The NHS and healthcare sector is second only to the whole of the private sector at losing computers, records and data.

The 75 breaches included 27 lost computers and laptops, 14 losses of paper records and 18 of removable media such as memory sticks.

Data was “inappropriately disclosed” on five occasions, there were two postal errors, one email error and one website security breach.

Eighty breaches in the private sector have been reported since November last year, 28 in central government, 26 in local government and 47 in other public sector bodies.

Information Commissioner Richard Thomas said reports had “soared” since the high profile loss of 25m child benefit records in autumn last year.

He said responsibility for data breaches should lay with chief executives, who should ensure appropriate policies and procedures are in place, that privacy is incorporated into their technology and that staff are properly trained.

“It is alarming that despite high profile data losses, the threat of enforcement action, a plethora of reports on data handling and clear ICO guidance, the flow of data breaches and sloppy information handling continues,” said Mr Thomas.

From:
http://www.hsj.co.uk/nhs_records_75_data_breaches_in_a_year

Connecting for Health, the ambitious plan to give every patient a comprehensive electronic record, has faced a series of problems over its size and complexity since it was first launched in 2002.

In May this year, the National Audit Office said the project was running at least four years late but still appeared “feasible”.

Since then, however, just one of the scores of acute care hospitals due to install the underlying administration system required in order for the patient record to work has done so. The hospital, Royal Free NHS Trust in London, continues to have difficulties getting it to operate properly.

In addition, the contractor originally hired to build the patient record system for the whole of the south of England, Fujitsu, has been fired. And BT, one of the two key remaining contractors, has been unable to agree a price for taking over the work Fujitsu had begun.

Health ministers originally promised the long-delayed first installation of patient record software in the north of England would finally take place in June at Morecambe Bay on the Lancashire/Cumbria border.

But four months on, the system has still not gone live and neither Morecambe Bay nor Connecting for Health can give a date when it might.

CfH’s most recent published plans for the next three months do not include a single installation of a patient administration system into any acute hospital trust.

And while NHS Trusts in the south – Fujitsu’s former area – are being given a choice of working with BT, the supplier for London, or CSC, the supplier for the north, none has yet signed up with either.

Jon Hoeksma, editor of the e-health insider website which has tracked the CfH programme from its start, said other parts of the £12bn project are continuing to make progress.

“But this key part seems to be simply stuck. It has ground to a halt. And that is not just affecting deployments that should be happening now. It will have a knock-on effect on those that are meant to be going live two or three years down the line.”

Hospital chief executives, he said, did not want to take a new system “until they have seen it put in pretty flawlessly elsewhere”.

Frances Blunden, the IT policy specialist at the NHS Confederation, the body that represents NHS Trusts, said: “It is a little bit too early to pronounce the programme dead.”

She said there were “undeniable” problems, but “to say everyone is walking away from it is a bit premature, probably”.

She said the health department had promised earlier this year to address hospital complaints that the system was too standardised and could not be adjusted to take account of local needs. “But we haven’t seen the implementation document to put flesh on the bones of that.”

A spokesman for Connecting for Health acknowledged that BT, which covers London, was “taking stock” given the difficulties encountered. The spokesman said it was more important to get the quality of installations right rather than promise delivery on a particular date. Talks with suppliers were under way to ensure “a smooth transition” in the south, after Fujitsu’s departure.

From:
http://www.ft.com/cms/s/0/b54a2e1c-a46e-11dd-8104-000077b07658.html?nclick_check=1

GP and broadcaster Dr Phil Hammond, said he and most doctors he has spoken to have opted for Gardasil, rather than Cervarix, for their own children as it also protects against 90 per cent of cases of genital warts as well as cervical cancer.

Writing online in the British Medical Journal, he said the issue has been overlooked because genital warts ‘never made it to the front cover’ of newspapers, but if it were breast cancer instead there would ‘marches on Downing Street’ to campaign for the choice of vaccine to be made available on the NHS.

There are two different cervical cancer vaccines on the market, Cervarix and Gardasil, which protect against the human papillomavirus which causes the disease.

The Government has chosen to offer Cervarix as part of a national vaccination programme for all girls aged 11 and 12 with a catch up campaign for older girls.

There are over 100 strains of HPV and Cervarix protects against the two which account for most cases of cancer whereas Gardasil works against an additional two strains so protects against other sexually transmitted conditions as well.

Gardasil remains available but only privately even though most other European countries have chosen it for their own national programmes.

Dr Hammond wrote that with 100,000 new cases of genital warts in England each year and condoms only reducing transmission by up to 50 per cent, the far safer option is to vaccinate with Gardasil.

But, although Gardasil is available privately to parents, at a cost of £350 to £400, most will not be able to afford it, he added.

The vaccine choice could be a false economy because of the estimated cost of treating genital warts is £23m a year and vaccinating with Gardasil would have begun to pay off within three to four years, he said.

According to Hammond, who is a vice-president of the Patients Association, with the current cost of treating genital warts estimated to be £23 million, the government’s decision may be a false economy. Within three or four years the use of Gardasil would have begun to have a considerable financial payback.

The NHS offers no information about Gardasil, raising serious questions over patient choice.

The Government’s vaccine advisors said that if both vaccines were offered to the NHS at the same price then it would recommend using Gardasil because of the extra protection and because Cervarix, made by Sanofi Pasteur, has been chosen it seems the decision has been made on the basis of cost.

Both vaccines are listed as costing £80.50 in the book of licensed medicines but the details of the discount offered by GlaxoSmithKline to the NHS in order to get the contract, remains ‘commerically confidential’.

From:
Doctors-do-not-back-cervical-vaccine-choice-made-by-ministers.html

Pupils will get basic classes in identifying body parts in the first few years of primary school.

In later years, they will be required to have more structured lessons about reproduction and relationships, a major review will recommend.

At secondary level, schools should improve the way issues such as civil partnerships and the importance of marriage are covered.

Teachers will also be given training in delivering lessons amid fears too many are embarrassed to discuss sex in the classroom.

The labour Government has already admitted that sex and relationship education across England is too “patchy”.

However, the move will be opposed by family campaigners who accuse ministers of subjecting pupils to controversial issues before they are ready.

To allay concerns, ministers are expected to announce a consultation ahead of the implementation of the lessons on whether or not to give parents an opportunity to withdraw their children.

In a further move, ministers will also announce a radical shake-up of the way children are taught about the dangers of drugs and alcohol.

Jim Knight, the Schools Minister, who has led the review, insisted exposure to sex education before puberty reduced teenage pregnancy rates.

“It is important that we as a society allow better sex and relationship education in both primary and secondary schools without sexualising young people too early,” he said. “It is right to share the responsibility between home and school.”

At present, all primary and secondary pupils have to learn about the biology of reproduction in science.

In primary schools, pupils should learn about how animals and humans reproduce, but can limit lessons to the biology curriculum.

Schools can also cover the subject in personal, social and health education, although it is not a compulsory part of the National Curriculum.

In secondary schools, teachers must go further, covering issues such as relationships and sexually transmitted diseases. Lessons on civil partnerships and marriage are also offered at secondary level as part of PSHE but they are non-statutory.

Mr Knight said he had received “many strong representations” for making PSHE statutory at all ages to address the problem of poor lessons.

Speaking in the Commons, he said: “The international evidence suggests that teaching aspects of sex and relationship education before puberty has a positive effect on such things as teenage pregnancy rates. Clearly, that has to be done with a high degree of sensitivity and… the involvement of parents, with children reaching puberty at different ages. We must ensure not only that, as a society, we are comfortable with the level of detail and of education that people receive during sex education, but that we are strong on relationship education.”

Leading charities including the Sex Education Forum and Brook, the sexual health advice service, which have taken part in the Government review, have already called for lessons to be compulsory in all schools.

It follows the publication of labour Government figures earlier this year showing that the number of abortions in girls under 16 last year rose 10 per cent to 4,376.

Norman Wells, director of the Family Education Trust, said making sex education mandatory would “seriously undermine parents”.

New-style lessons on drugs and alcohol lessons will also be overhauled.

Primary school pupils will be given warnings on avoiding medicines and prescription drugs left in the home – as well recognising the difference between soft drinks and alcohol.

Stephen Burgess, national director of Life Education Centres, the health charity, said: “If we want to make a real and lasting difference to teenage drug and alcohol misuse, we must reach them early – at primary school. Then, as they reach adolescence and are most at risk from peer influence, they can make informed decisions based on fact rather than hearsay.”

*Health officials were forced to apologise after sending letters to children as young as nine, demanding they are tested for sexually transmitted diseases.

Primary school children were also offered the chance to win an iPod if they attended a clinic for testing. A primary care trust in Harrow blamed an administrative error.

Geraldine Smith, the Labour MP for Morecambe and Lunesdale, told the Telegraph: “To start sex education at primary school is to rob young children of their innocence. I know children seem to grow up faster these days but to start formally teaching them about sex education would be quite wrong and would encourage under-age sex. Being exposed to this sort of thing at such an age would put an awful lot of pressure on very young children.”

From:
Children-aged-five-to-get-sex-education.html

A joint memo circulated this week by the department and the Association of the British Pharmaceutical Industry, the trade body, warns that there will now be a delay of at least three months in implementing one part of the arrangement negotiated with industry over the summer.

In spite of having had months to prepare for the new arrangement, which had been due to come into force by the start of next year, the Department of Health has also failed to develop a system to monitor drug prices systematically, which is essential for implementing another part of the new deal.

The moves are fresh blows to relations between the pharmaceutical sector and the government, which sparked industry ire last year when it unilaterally decided to scrap the present Pharmaceutical Pricing Regulation Scheme, which determines how drug prices are set.

One pharmaceutical industry official said the issue was causing a “furore” in the sector and said it would take at least several weeks to clarify the full implications and how to respond.

The memo circulated last week says that industry will not now be expected to cut the price of off-patent branded medicines from January 1, as had been previously agreed, since the department decided it needed to hold a public consultation on the issue.

In the short term, the uncertainty means that the NHS will be sacrificing an estimated £80m in annual savings from price cuts in these so-called branded generics or “loss of exclusivity” medicines.

But the delay also creates uncertainty over how to implement the entire PPRS deal, which gives companies flexibility over how much they charge the NHS for individual medicines, provided there is an overall price cut of 5 per cent in the £8bn annual total.

Under the agreement reached with the pharmaceutical industry this summer, 3.9 per cent of the annual savings were des-igned to come from price reductions on patented medicines, and a further 1.1 per cent from the off-patent brands.

The new deal was supposed to reduce the price of branded generic drugs to 1.5 times the government’s reimbursement level set for generic medicines. Generic drug manufacturers fear they may lose out if this ratio is modified as a result of the latest department consultations.

A second aspect of the PPRS raises the possibility of fresh price cuts, on top of the 5 per cent scheduled for the start of this year, if drug prices rise too fast.

From:
http://www.ft.com/cms/s/0/de162cfc-a099-11dd-80a0-000077b07658.html?nclick_check=1

PFI deals are still being negotiated – not without difficulty – in spite of the credit crunch as some banks see their government-backed revenues as a haven in the financial turmoil.

However, the credit squeeze has seen funders demanding higher margins on the debt put into them and that has opened up the possibility again of significant refinancing gains if investment and interest rates fall to pre-credit crunch levels.

In a move to avoid the acute embarrassment of the early days of PFI, when investors in projects made millions of pounds from refinancings and it turned out that the taxpayer had no right to any share in the gains, the Treasury has upped the share it is demanding.

Investors in one of the early hospital projects, for example, made a 60% windfall gain and hugely increased rates of return when they used falling interest rates to refinance. As a result, since 2001 contracts have required that any such gains should be split equally between the project’s backers and the taxpayer.

That will still apply to the first £1m of any gain. But for new deals the Treasury said yesterday that the next £2m would have to be shared 60/40 in the taxpayers’ favour and for anything above that the taxpayer would take 70 per cent.

As an additional protection, new contracts will give the public sector the right to demand a refinancing if it believes that will lead to better terms for the taxpayer, whereas previously only the contractors have been able to initiate such a deal.

In spite of the onset of the credit crunch last year, more than a dozen PFI deals have been signed this year, according to the Treasury, eight or nine of them in the second half of the year, despite the growing problems over bank lending.

Almost £600m of schemes by capital value have been agreed since the middle of the year, though most have been smaller deals in the £20m to £90m range.

Some European banks have withdrawn from the PFI market, and James Stewart, chief executive of PUK, the public-private partnership that advises the public sector on deals, said recently that sponsors had had to go to clubs of several banks to arrange financing – rather than doing a deal with one or two that then sold the debt on.

From:
http://www.ft.com/cms/s/0/ed45ca68-9be2-11dd-ae76-000077b07658.html?nclick_check=1

The most comprehensive study of its kind has shown that millions of people are being failed by their local surgeries.

Under key NHS targets, patients should be able to see their family doctor within two working days. However, the report said that just one third of people were able to see their GP within this time.

The findings come at a time when the relationship between patients and their doctors is already under strain.

There has been widespread anger over the large pay rises enjoyed by GPs under the new contract.

And ministers and GPs have been locked in bitter negotiations about forcing surgeries to open for extended hours, offering appointments into the evening, early in the morning and on Saturdays.

Gary Needle, at the Healthcare Commission, said: “Patients are not getting sufficient access to their GPs is the message from this measure.”

Andrew Lansley, Shadow Health Secretary said: “Despite all their talk, Labour are still failing patients when it comes to choice and access to a GP.

“It’s appalling that in seven out of ten areas, people aren’t able to see their doctor within 48 hours when they wish. It shows the utter failure of Labour’s top-down targets to bring about the best results for patients.”

Liberal Democrat health spokesman Norman Lamb said: “For years people have known that ministers’ complacent assurances about how easy it was to see a GP were wrong.

“At last a proper assessment has taken place so we can see the reality of the situation. This scandalous finding must force the Government to act now.”

Last year the report found that 80 per cent of patients were able to see their GPs within 48 hours.

However, the data was gathered by using ‘mystery patients’ to carry out spot checks to see if they could get an appointment rather than asking patients.

This year, for the first time, the commission included information from a patient survey. The report has sparked a row with doctors who have said the figures are misleading.

Dr Hamish Meldrum, chairman of the British Medical Association said: “The report’s conclusion that there has been a dramatic decline in primary care trusts meeting the GP 48-hour access target is misleading.

“There has been such significant change in the way the research has been compiled compared to last year that it is impossible to compare the data for the two years in question. The access figures are even more confusing when you consider that a recent survey showed almost 9 out of 10 patients were satisfied that they were able to get an appointment within 48 hours.

“GPs are working hard to offer as much flexibility as they can to patients, as well as providing speedy access, and delivering an expanding range of services to patients.”

The latest figures show the average annual earnings of GPs, who are paid to hit the targets on appointments, are £103,530 – a drop of 2.6 per cent on last year after years of rising pay. They also showed 258 doctors earned more than £250,000 before tax last year.

The commission’s healthcheck is an in-depth investigation into the NHS with each hospital trust, primary care trust, mental health trust and ambulance trust measured on waiting times, hygiene, confidentiality, management of records, reducing deaths from cancer and heart disease, cutting superbug rates and treating patients with dignity and respect.

While the report found there had been improvements in many areas, it found that infection control was a serious problem with ‘lapses at almost every trust visited’ and six out of ten trusts failing on at least one measure.

The Commission warned that other infections such as norovirus – the winter vomiting bug that reached record levels last winter – should be included in the measures in the future alongside Clostridium difficile and MRSA.

Of the 114 trusts that failed on at least one infection control measure, 11 said they were compliant only for this to be overturned by inspectors.

There is concern about infection control in community hospitals, district nursing, ambulances and midwifery and these areas will have extra focus in the next inspections.

From:
Two-thirds-of-patients-fail-to-get-GPs-appointment-within-48-hours.html

Premature baby charity Bliss found just 20% of UK hospitals had enough staff to meet recommended care guidelines.

The study of 194 neonatal units showed that more than 50% had been forced to close to new admissions during a five-month period because of shortages.

The charity said it was shocking that such problems were persisting.

Each year, more than 80,000 babies – 10% of the total born – need specialist care in a neonatal unit – usually because they are underweight or premature.

Bliss surveyed all 213 British hospitals with neonatal units about care, from April to September 2007, and 91% of those asked responded.

They found that only 21% of the hospitals which responded had enough staffing to provide the recommended nurse to baby ratios.

These vary between one-on-care in intensive care wards to one nurse to every four babies on the least-intensive special care baby units.

To meet the recommended guidelines the charity said it believed an extra 1,700 neonatal nurses were needed in addition to the 6,500 already employed.

More doctors were also needed, it added. But it warned there had been a lack of progress made in neonatal care over the years.

This is the fourth report the charity has produced highlighting the issue. Over the last year fewer than 200 extra nurses have been recruited.

The charity also polled more than 300 parents who complained of being transferred between hospitals – sometimes over long distances – because of staffing shortages.

Bliss chief executive Andy Cole said: “Professionals are increasingly being stretched to the limit.

“Staffing shortages are all too apparent on units and the care of our most vulnerable babies is being compromised.

“No other critical care service would permit the capacity and staffing levels seen on special care baby units.”

David Field, president of the British Association of Perinatal Medicine, agreed the staff shortages were worrying.

He added: “We would like neonatal care to be given the same kind of priority that other specialist services such as cancer care or A&E; have received.”

But a Department of Health spokesman said there was no evidence that services were “unsafe”.

“We are committed to providing mothers and babies with safe, high quality neonatal services and have made neonatal services a top priority for the NHS.

“However, we recognise there is still more to do.”

Meanwhile, a spokeswoman for the Scottish government said that a review of neonatal care was currently taking place.

She added: “The Scottish government is committed to providing the best possible care for premature babies.”

From:
http://news.bbc.co.uk/1/hi/health/7669634.stm

The failure fully to cover the basics comes despite a big improvement in the health service’s performance over the past three years, the commission said in its annual “state of the nation” report on the NHS.

From April 2010, NHS hospitals and organisations will go through a registration system that will issue them with a licence to operate.

But while two-thirds of NHS organisations and 70 per cent of acute hospitals meet all the core standards laid down by the Department of Health, and a further 25 per cent are judged to be almost there and therefore likely to meet the standard for registration, about 10 per cent of NHS organisations and hospitals are still some way from the target.

“If they don’t meet these core standards,” said Sir Ian Kennedy, chairman of the Healthcare Commission, “then the Care Quality Commission could withdraw registration or impose tough penalties such as fines or operating conditions.

“I would urge trusts to get their act together with all appropriate urgency.”

Baroness Young, chairman of the Care Quality Commission, which next April replaces the Healthcare Commission as the inspectorate, has said she thinks it “very unlikely” that an entire NHS hospital will be refused a licence to operate.

“I doubt there will be many to whom we say: up with this we cannot put; we will not register you,” she has said.

But hospital departments and services could find themselves operating under strict conditions and improvement plans, with the inspectorate holding tougher enforcement powers than the existing one. The warning that a small minority of NHS organisations have a long way to go to hit standards came as the inspectorate’s annual check showed significant overall improvements in performance.

From:
http://www.ft.com/cms/s/0/b495c044-9b18-11dd-a653-000077b07658.html?nclick_check=1

Professor Mike Richards, the cancer tsar for England, has been holding a review about so called co-payments and will report at the end of this month. The issue is also under review in Wales and Scotland.

But patients are already topping up their NHS care, as hospitals find ways around the current rules.

The current rules say you cannot mix and match between the NHS and private.

You are either all NHS and it is free or you’re all private and you pay for everything.

But the details are interesting. The code of practice says a patient cannot be both an NHS patient and private in the same episode of care.

So in Birmingham they have found a way round the ban on top ups.

Separately another consultant at the same hospital writes a private prescription for the drugs that patients wants to keep them alive.

They are supplied at patients’ homes by a private company called Healthcare at Home.

They pay the company direct. So the administration of the drugs is viewed as a separate episode of care.

Professor Nick James is the oncologist in Birmingham who designed this model of allowing patients to top up their care.

“Nowhere does it say that an episode of care is from diagnosis to death of your cancer” he said. “So we’ve just interpreted the rules in a way which is in favour of the patients.”

Across the country

What is remarkable is that topping up, something the labour government says is banned, is not just happening in Birmingham.

The company which provides the drugs to Ian says they have contracts with 30 NHS hospitals across the country.

Mike Gordon, chief executive of Healthcare at Home, said: “Top ups are happening today and they’ll happen tomorrow. So long as they’re done through us not using the auspices of the NHS I see no reason why they shouldn’t continue.”

A Department of Health spokesperson said: “We know there is variation in how individual Trusts are applying the current guidance, and that is why the Secretary of State asked Professor Mike Richards, National Clinical Director for Cancer, to lead a review into this difficult issue.

“Professor Richards is looking at how a consistent approach across the country might be best achieved.”

Shadow Health Secretary Andrew Lansley said: “David Cameron and I have pressed the Health Secretary, Alan Johnson, to enter into a risk sharing scheme for the kidney cancer drug Sutent in order that patients will be able to access this life saving treatment immediately, but nothing has been done.”

Norman Lamb, for the Liberal Democrats, said: “We are in an outrageous situation where patients are left in a lottery, dependent on a few hospitals which are bending the rules.

“This case makes the need for reform all the more urgent.”

All Ian Jenkins wants is to stay alive as long as possible.

But his story does raise the question, why the need for a high level review of top ups if they are already happening all over the country?

From:
http://news.bbc.co.uk/1/hi/health/7668121.stm

A breakdown in the patient-doctor relationship would in turn lead to more ill health, researchers warn.

More than 1.3 million patients signed a petition against the proposals for large scale polyclinics earlier this year.

GPs argue that patients will lose the bond with their family doctor under the plans, which include housing large numbers of GPs under one roof along with specialisms such as minor surgery and dentistry.

The British Medical Association (BMA) has warned that patients will be unlikely to see the same doctor each time they visit a polyclinic.

The labour Government insists that the changes are necessary to give patients a “world class” service and that, outside London, the clinics will provide extra capacity in so-called under-doctored areas.

The new study shows that patients trust family doctors less if they often have to see different GPs.

Researchers surveyed 243 patients registered at three different surgeries.

They found that 83.5 per cent of patients who always saw their regular GP had a high level of trust in their doctor.

That figure fell to just 72.6 per cent of those who often saw different GPs, the research, published online in the British Journal of General Practice, shows.

Dr Carolyn Tarrant, part of the team which carried out the study at the University of Leicester, said: “The government is setting up numerous polyclinics, super-surgeries, and walk-in centres all over the country.

“I’m sure they will have various benefits for patients and GPs, but they are bound to reduce continuity of care, and our research shows that this may lead to a decline in patient trust. If patient trust declines, then medical outcomes may be adversely affected.”

Dr Laurence Buckman, chairman of the BMA’s GP Committee, said: “Trust and continuity of care are exactly the reasons why general practice can’t be delivered supermarket style, where choice and convenience come above everything else.

“For someone with a chronic condition, a long-term relationship with a doctor they trust and who knows their history is vital.

“GPs and patients believe polyclinics will damage that relationship, it’s just the labour Government that doesn’t.”

The proposals were set out by Lord Darzi, the health minister, as part of his root and branch review of the health service.

A spokesman for the Department of Health said that the “overriding objective” of the new centres was to deliver the best possible service to patients.

From:
Polyclinics-will-destroy-trust-between-patients-and-GPs.html

Hull Primary Care Trust (PCT) will buy the 72ft (22m) boat if funding is secured to set up a new organisation called the Wilberforce Sailing Academy.

The project’s aim is to give unemployed 17 to 19-year-olds a healthier lifestyle and something to do.

Councillors and union officers said the scheme was a misuse of money.

The initiative is likely to be backed by more than £1m of public funding through One Hull, which brings together public, private, voluntary and community sectors.

It has been inspired by the success of the Hull-based Clipper Tag Team, which saw youngsters from across the region join the crew of the Hull and Humber Clipper in the recent round the world yacht race.

Chris Long, chief executive of the PCT, said youngsters would go on trips on the yacht and learn a range of skills such as plumbing, electronics and carpentry.

“They will learn a range of skills which will enable them to be a safe crew member on the boat and at the same time we expect them to build a degree of aspiration which might not have been there previously,” he said.

“After that they will undergo training in things like CV writing, interview skills and job applications. It doesn’t just finish when they get off the boat, there’s almost a year-long package.”

Councillor Steve Brady, opposition leader on Hull City Council, said it was a “disgraceful” misuse of public money.

“Any spare cash the PCT has should be used on patient facilities,” he said. “I believe this sort of money could have funded long-term apprenticeships to give real skills to young people in Hull. Surely we should be helping these young people get into the real world of work rather than going off on a yacht for a couple of weeks.”

Terry Cunliffe, regional officer for union Unite, said: “While it is laudable to support schemes to help disadvantaged children, I think these costs are better met from social services and educational bodies.

“If the trust has managed to make a surplus, then that could have been ploughed into protecting them if they face financial difficulty or invested in patient care.”

Final decisions on funding will be made by One Hull’s executive group in November.

From:
http://news.bbc.co.uk/1/hi/england/humber/7669689.stm

The money was used to bring in physiotherapists to help workers recover from muscular skeletal injuries at West Suffolk Hospital in Bury St Edmunds.

Bosses said it prevented them from leapfrogging NHS patients and enabled them to return to work more quickly.

However, the private treatment, which amounted to £12,116 for 271 appointments over the past year, was described by critics as “shocking”.

Mark Wallace of the TaxPayers’ Alliance said: “Their staff should have to wait like everybody else. “Perhaps if they experienced it as their customers – that is the taxpayer – experienced it, they might be a little keener to improve their waiting times.”

Frances Jackson, a patient who receives physiotherapy treatment from the hospital, said: “It’s great that staff are being catered for because there is a need for it – they do get work-related injuries which can lead to osteoarthritis.

“But what about everybody else? There’s an amazing amount of people who can’t afford private physiotherapy. They need to appoint more physiotherapists and bring the waiting lists down.”

Jan Bloomfield, executive director of workforce and communications at the hospital, said: “In line with national best practice, and with policies adopted by other major employers, we offer a physiotherapy service to help staff with specific work-related problems.

“Staff must meet very precise criteria to receive the service, which offers good value for money as it helps them get back to work quickly so they can continue to provide high quality care to our patients, avoiding the need to draft in expensive locum care.”

She added: “Funding for the service is generated by our occupational health team, who go into businesses to advise on health and safety, and is not taken from budgets set aside for patient care.

“We are currently looking at whether it would be cost-effective to extend the service to offer different types of rehabilitation to staff.”

From:
NHS-trust-spends-12000-treating-staff-privately.html

Parental consent is not required for the Cervarix vaccination, which is being administered to 300,000 girls in an attempt to cut down incidents of the fatal disease.

But girls are supposed to give consent themselves before being given the jab and Debbie Jones, from Orkney, claims her daughter did not do so.

The vaccine counters the effects of the human papilloma virus, which is transmitted through sexual contact later in life, but some parents and religious groups have argued that the life saving injection encourages promiscuity.

Mrs Jones, a Christian, said: “We all discussed it at length as a family. I just didn’t feel comfortable with it. I told my daughter that if she really wanted it, she could have it, but she agreed with me.

“I couldn’t believe it when she came home and said they’d given it to her anyway. She didn’t say yes or no because she was never directly asked. They talked to her then just gave it to her.”

Mrs Jones says she believes her daughter should not have the injection because she is too young and suffers from diabetes but health professionals at Stromness Academy went ahead anyway.

Orkney NHS trust said it was launching an investigation.

“We take this complaint extremely seriously and will be investigating fully as a matter of urgency,” a spokesman said. “If there are lessons to be learned they will be incorporated into the vaccination programme in Orkney.”

The jab is to be given to every 12 and 13 year old girl in a programme it is hoped will save 400 lives a year. A catch-up programme will focus on girls aged 14 to 18 over the next two years.

From:
Cervical-cancer-jab-given-without-consent.html

The National Audit Office (NAO) found that while 14 per cent of patients were unhappy with their NHS service, less than one per cent made a formal complaint to their health trust.

There was also little evidence of services improving as a result of complaints made.

It also found that one in five health trusts took too long to respond to patient complaints.

While most met the target of an average of 25 working days to answer complaints, one took 55 days, more than twice as long.

Edward Leigh, Chairman of the Commons Public Accounts Committee, said that the reason so few patients make formal complaints is that they have “no confidence anything will be done as a result”.

“Complainants are often confronted with a defensive and unhelpful response when sometimes all that is needed is a simple apology or a promise to improve services.

“There is also little evidence that complaints are leading to better services. This is no way to keep people’s faith and trust in health and social care services.”

The criticism comes after David Cameron, the Conservative leader, attacked Alan Johnson, the Health Secretary, for an allegedly cold and bureaucratic response to a complaint over the
death one of his constituents, Elizabeth Woods, after she contracted the superbug MRSA.

There were 133,600 official complaints about the NHS last year.

A spokesman for the Department of Health said that ministers agreed that the NHS had to be better at handling complaints and that was why a new, simplified system would be introduced next year.
NHS-complaints-system-too-bureaucratic-for-patients-says-report.html

Two years after the NHS in England recorded a £547m deficit, with local auditors highly critical of the level of financial control in many trusts, half of NHS organisations are performing well in their use of resources, the commission said.

But a mere 14 of the 300 NHS bodies surveyed achieved top scores in every category for the use of NHS money and some 20 – a significant minority of them in London – failed to reach minimum financial standards.

Improvements in the way the money is managed over the past year have been “impressive”, Michael O’Higgins, the Audit Commission chair, said. “However, pockets of real concern remain. Poor financial management can put services for patients at risk,” he added.

“The challenge . . . is to raise standards to those of the highest-performing organisations,” the commission said.

The analysis covers hospitals, primary care and ambulance trusts but excludes NHS Foundation Trusts, which tend to include better-performing organisations and whose finances are overseen by their regulator, Monitor.

From:
http://www.ft.com/cms/s/0/cac9a900-901b-11dd-9890-0000779fd18c.html?nclick_check=1

Mr Hope takes over the social care portfolio. The department is in the middle of an emotive debate on the future shape of care and support, intended to precede a green paper on reform of social care funding.

The controversial debate has increased in profile as more people have become concerned over the anomalies in the present system and the growing number of older people.

Mr Hope has been given the brief as a minister, whereas Ivan Lewis was a junior minister in the department.

Mr Hope is expected to inherit most of Mr Lewis’s previous ministerial responsibilities, including the third sector and social enterprise. Until the reshuffle this weekend, Mr Hope was minister for the third sector at the cabinet office.

Before that, he was a skills minister in the Department for Education and Skills and a parliamentary under-secretary of state in the Office of the Deputy Prime Minister, where he had responsibility for local government.

Mr Hope’s other responsibilities at the Department of Health are likely to include:

* the DH’s relationship with local government;
* mental health;
* dignity and respect;
* equality and human rights.

Mr Hope is also minister for the East Midlands.

His website lists tennis, juggling and computing among his hobbies.

Ivan Lewis, who until yesterday was the longest standing minister at the DH, has been moved to a junior ministerial post at the Department for International Development.

From:
http://www.hsj.co.uk/news/2008/10/phil_hope_takes_over_social_care_brief_at_dh.html

A mother of three has died from cancer after her family was forced to pay £20,000 for treatment she was denied by the National Health Service because she had bought a drug privately.

Carole Simmons, 59, died last Tuesday, the third person known to have died after suffering from the labour government’s policy of withdrawing NHS care from patients who buy top-up drugs.

Her death comes in the middle of a government review of top-up treatment, which was ordered after a campaign by The Sunday Times exposed the scandal. The review panel is due to report to Alan Johnson, the health secretary, later this month.

This weekend relatives of Simmons, who lived in Yapton, West Sussex, spoke out in the hope of sparing other families from suffering the same tribulations. Simmons’s husband Kevin, 59, a former divisional officer in the fire service, described what happened when she was diagnosed with bowel cancer last December.

“They more or less said that Carole had no hope, that she only had weeks to live,” he said. “They were sending Carole home to die.”

In an attempt to give Simmons more time, her family paid privately for a drug called Avastin, which was not available on the NHS. They believe it prolonged her life.

However, under labour government rules their NHS treatment was then withdrawn. As well as the cost of Avastin, the family had to pay about £20,000 for routine drugs, scans and consultant appointments that would otherwise have been available on the NHS.

“We got nine precious extra months with Carole which we may not have had if we didn’t have the money,” said Simmons. “We want Carole’s legacy to be that this policy will be changed so that this doesn’t happen to anyone else and top-ups are allowed.”

During the extra time she was given, Simmons, a former teaching assistant, saw a grandchild start school, enjoyed a family holiday in France and attended her sister’s 40th wedding anniversary in Jersey.

Simmons’s youngest son, Chris, 28, a solicitor, said: “Some people may be able to raise the money for the extra cost of the drug but they may not be able to pay for all the treatment, such as scans and consultant fees. Instead of ordering a review, Gordon Brown should have ended this immediately and allowed people to pay just for the extra cost of the drugs.”

He added that paying for Avastin had given “us time to put our affairs in order and to say our goodbyes”.

Simmons’s daughter Kate, 30, a civil servant, points out that her mother had paid for her NHS care. “Our mum worked all her life, apart from when she was bringing us up. She never claimed unemployment benefit and always paid her national insurance and taxes,” she said.

“Our mum really wanted us to speak out so that this would not happen to another family.”

The Simmonses paid for the drug and basic NHS care from savings and a loan. “This was my parents’ pension savings. They didn’t have the money lying around,” said the eldest son Colin, 35, a local government manager.

Simmons was treated at St Richard’s hospital in Chichester before her NHS care was withdrawn. She then paid for Avastin and her treatment, including scans using NHS equipment, at the Spire Portsmouth hospital in Havant.

The Royal West Sussex NHS Trust, which runs St Richard’s hospital, said it was following government guidance by refusing to allow Simmons to continue to receive NHS care while paying for the Avastin.

The government inquiry, which is being carried out by Professor Mike Richards, the government’s cancer czar, was ordered in June following the disclosure in The Sunday Times that another bowel cancer patient, Linda O’Boyle, 64, from Billericay, Essex, had died after her NHS care had been withdrawn because she paid privately for the drug Erbitux.

In May last year Sandra Baker, 62, from Walgrave, Berkshire, died of bowel cancer after being denied NHS treatment because she paid for a drug.

Simmons is the first patient known to have died during the government inquiry after being denied NHS treatment. She would have celebrated her 40th wedding anniversary today.

Her local MP, Nick Herbert, the shadow justice secretary, said: “I am horrified that my constituents have had to use their savings in this way. The awful situation at the moment is that if you do manage to scrape together the money to buy these drugs yourself, your NHS treatment is withdrawn. This puts patients in a terrible dilemma.”

Most leading health organisations, including the British Medical Association, the Royal College of Nursing (RCN), the NHS Confederation, which represents hospital managers, and the King’s Fund and Reform think tanks, have said top-ups must be allowed.

The Roy Castle Lung Cancer Foundation and the Patients Association have both backed top-ups in their submissions to the inquiry.

While the RCN accepts that allowing top-ups is necessary, nurses’ leaders warn that the change could create “business class” treatment for NHS patients who can afford it and thus potentially undermine the founding principles of the NHS.

Others argue that there is already a two-tier health service, as those who can afford to pay for all their care go to private wings of NHS hospitals.

The government inquiry, to be published at the end of this month, is expected to propose that patients should be allowed to pay for additional drugs without losing their NHS care.

Kate Spall of the Pamela Northcott Fund, which campaigns on behalf of patients denied drugs on the NHS, said: “Let us hope that Carole’s tragic story will bring about the end of this situation for patients.”

From:
http://www.timesonline.co.uk/tol/news/uk/article4882645.ece

Patients were given the right to pick any hospital- public or private from April, but the latest figures from the Department of Health show that only 9,400 NHS patients chose a private hospital in the four months to the end of July.

Some doctors and NHS trusts are doing little to encourage patients’ right to choose and in some cases are actively discouraging it, the operators say.

Richard Jones, commercial director of Spire Healthcare, formerly Bupa Hospitals, told a private health convention held by analysts Laing & Buisson that the proportion of NHS work varied widely around the country, from “virtually none” in some places to “certainly a third of our work” in others.

Ramsay Health Care, another of the bigger private hospital chains, said it was experiencing the same variations. Numbers are rising, however. In July almost 3,000 opted for a private hospital – double the number in January. That generated £6.5m of income for private hospitals.

On top of that, many thousands more NHS patients went to the independent sector treatment centres (ISTC) set up specially to treat them, either out of choice or after being steered there by primary care trusts, which in many cases have to pay for the admissions whether or not they are used. ISTCs earned £29.4m from NHS patients in July.

The independent sector’s income from NHS patients is £400m a year, plus additional work when the NHS buys operations to keep down waiting times.

“There’s still quite a lot of local contracting as the NHS buys operations to stop patients breaching waiting-time targets,” Mr Jones told the conference.

However, fewer than 5 per cent of non-urgent, elective procedures are being purchased from the private sector – a far cry from the “up to 15 per cent” that John Reid projected when he was health secretary in 2004.

Ben Bradshaw, the health minister, admitted: “There is still a cultural reluctance to really drive home to the public that they have a choice. We need a big drive on that, both with general practitioners and primary care trusts.”

Mr Bradshaw said he remained convinced that the number of NHS patients treated privately “will continue to grow”.

The health department is establishing a website on which primary care trusts will have to advertise all tenders for NHS work, making it easier for the private sector to find out what business is available and where.

Primary care trusts are now routinely expected to put all new work, or significant changes to existing provision, out to tender.

From:
http://www.ft.com/cms/s/0/cac9a900-901b-11dd-9890-0000779fd18c.html?nclick_check=1

An assessment of the system at the first hospital to launch it, the Royal Free Hampstead NHS Trust in north London, details a catalogue of software glitches and design faults. It warns that the problems pose a possible “risk to patients by underestimation of clinical condition”.

According to the document, the system, which is being used in the accident and emergency department, is routinely crashing, patient information is intermittently “lost” and some staff are reverting to pen and paper. Extra staff have been drafted in to help cope.

Tony Collins, executive editor of Computer Weekly, said the document, disclosed by an NHS employee, warned that some of the problems could “continue indefinitely”.

He said: “This is the centrepiece of the Connecting for Health programme [the government’s plan to computerise NHS records] and it isn’t working properly.”

Hospital officials said this weekend that continuing problems were being “vigorously” pursued with the contractors while staff were being vigilant to ensure patient safety was not compromised.

The report is the latest setback for the £12 billion Connecting for Health programme, which was meant to provide a single nationwide IT system for the NHS containing records for every patient by 2010.

While some elements of the programme have been introduced ahead of schedule, the patient record system has been beset with delays and software problems.

Last June the Royal Free became the first trust to launch the most advanced version. To protect patient confidentiality, records can be accessed only with a swipe card and a code.

The launch was a key test for Connecting for Health, which has faced questions about the reliability of its systems and whether patient confidentiality could be easily compromised with computerised records. Two months after the launch there were reports of missing data and delays in booking patient appointments.

Now an assessment of the new system at the Royal Free has uncovered a series of problems, which appear to be unlikely to be fixed in the short term.

The Royal Free Hampstead NHS Trust said the implementation of the new system was initially better than expected but there were continuing problems that would “take some time” to rectify.

From:
http://www.timesonline.co.uk/tol/news/uk/health/article4882792.ece

UK companies on average spend 7 per cent of their total payroll costs on healthcare schemes, compared with 5.3 per cent across Europe.

Only Switzerland (11.3 per cent), Bulgaria (8.8 per cent), Romania (7.5 per cent) and Turkey (7.3 per cent) pay a higher proportion of payroll costs on employee healthcare benefits, according to consultants Mercer, which surveyed almost 800 employers in 24 European countries.

This was still far lower than the US, where employers spend 15.4 per cent of payroll on health benefits.

Employers in European countries, such as the UK, which fund public health through general taxation, spend more on health benefits than countries that operate government-sponsored social insurance schemes, into which citizens pay directly, said Mercer.

It added: “This may reflect a concern that public health systems [funded out of general taxation] do not meet employers’ objectives and, hence, there is a greater perceived need to provide supplemental health benefits.”

The cost of healthcare schemes to employers has risen sharply in recent years – increasing by 5 per cent per employee last year across Europe as a whole and 5.9 per cent in the UK – as medical costs increased.

The average cost of providing medical cover for employees and dependants has risen by 67 per cent in he UK since 1999, according a separate survey conducted earlier this summer. This has placed an increasing burden on employers. More than half of European employees do not pay towards their employer-provided health benefits, compared with the US, where employees commonly pay around a quarter of the cost.

Despite the rising costs, many companies expected to maintain healthcare schemes in order to retain and attract staff. Some 41 per cent of European employers were unlikely to make any changes at all to their programmes, according to the consultants’ latest survey.

Concern over rising costs, however, was reflected in the fact that 38 per cent expected to restrict the scope of coverage, while 34 per cent said they would shift some of the cost to employees. Others were considering offering flexible benefits “to manage costs and better match employee requirements”, said Mercer.

Steve Clements, head of Mercer’s health and benefits business, said: “Over two- thirds of respondents said they would struggle to retain top-performing employees if they did not offer good health benefits. These programmes are particularly valued as a staff attraction tool by companies in emerging eastern European countries, where migration to western economies has produced a scarcity of talent.

“Health benefits often rank as the most highly valued company benefit in countries where employees perceive national health provision is relatively poor.”

From:
http://www.ft.com/cms/s/0/fa1fc904-8f4f-11dd-946c-0000779fd18c.html?nclick_check=1

This is despite rulings from the labour Government’s new prescribing watchdog that the treatments should be freely available on the NHS.

Doctors say that diabetes, arthritis and Alzheimer’s patients are suffering because they are being refused drugs or treatment programmes approved by the National Institute for Curbing Expenditure (NICE).

The agency was set up in 1999 following concerns that patients in some health authority areas were being denied new treatments because they were too expensive. Nice recommends which new treatments should be given to all patients and which are too costly or ineffective to be funded by the taxpayer.

Doctors say that many hospitals still lack the resources to prescribe drugs recommended by Nice. Patients are continuing to miss out, they say, because of staff shortages and a failure to fund the equipment needed to administer the treatments.

In March last year Nice ruled that anti-TNF alpha therapy – a revolutionary infusion for rheumatoid arthritis – should be available to about 25,000 patients who fail to respond to conventional drugs. Anti-TNF can prevent those with severe arthritis from becoming crippled by the condition, which afflicts 380,000 people in the United Kingdom and is the country’s commonest cause of disability.

A year later, however, a survey by the Arthritis and Musculoskeletal Alliance (Arma), which groups 27 patient organisations, found that more than a third of rheumatologists were still unable to prescribe the drugs to all the patients who needed them.

The 152 consultants in England and Wales who responded to the survey identified more than 1,000 people who were still on waiting lists for the treatment.

Many specialists said that a key factor in the failure to give the drugs to patients was the lack of funding for the specialist nursing needed to administer the treatment. Sophie Edwards, Arma’s chief executive, said: “There are patients around the country who are being denied the treatment they drastically need.

“The survey results show that access to this clinically proven and cost-effective treatment still depends on where you live.”

Dr Andrew Bamji, of Queen Mary’s hospital in Sidcup, Kent, told The Telegraph that he was relying on his secretary to take on the clinical duties needed to administer the treatment to patients with severe arthritis.

“I’m having to rely on my secretary to do some of the work that should be done by a nurse,” he said. “But even with her help, we’re getting to the point where we can’t see any more patients.”

Dr Richard Sullivan, the head of clinical programmes at Cancer Research UK, said that a lack of resources was also affecting cancer patients.

He revealed that Herceptin, a breast-cancer treatment that costs £20,000 a year per patient, was not available in many parts of the country despite a Nice ruling last summer that it should be available to all women with advanced breast cancer who might benefit from it. This means about 5,000 people each year.

“There are plenty of places around the country that aren’t giving Herceptin because they’re not able to do the tests needed before the drug is given,” he said.

Diabetes sufferers are also being denied effective treatments.

In January, Nice ruled that all patients whose blood sugar was not properly controlled by traditional insulin injections – at least 4,000 people – should be given funding for insulin pumps. Without them, sufferers risk blindness, amputations, kidney failure and even death.

It is now becoming clear, however, that not all health authorities are abiding by Nice’s ruling. John Davis, 64, a patient at the Royal Bournemouth Hospital, is having to pay £1,000 a year for a pump because his local health authority is not funding the service.

Mr Davis set up a support group in April, and has since been contacted by dozens of fellow diabetics, mostly from Dorset, Oxfordshire and Northamptonshire, who are also unable to get the treatment on the NHS. “We have people who’ve been refused treatment even though their consultant has told them they should have it,” he said. “But many other patients are getting it. It isn’t fair.”

The extent of the so-called postcode lottery – in which treatment is available in some health authority areas but not others – is also illustrated by the patchy availability of the latest treatments for Alzheimer’s disease.

In the Greater Manchester area, no new patients in Salford have received anti-dementia drugs since January. Only 10 miles away in Bolton, however, people are being seen quickly by a service tailor-made to administer the treatments.

Dr Mahendra Gonsalkorale, a consultant geriatrician at Hope Hospital in Salford, said: “This really is not acceptable or fair. In the UK in general there should be similar access to these drugs for everybody.”

The Alzheimer’s Society says similar problems exist in Lancashire, Shropshire and Yorkshire. The reason is not a lack of drugs but the lack of staff to administer them.

Dr Evan Harris, the Liberal Democrats’ health spokesman, said: “The Government doesn’t figure in the total cost of Nice recommendations, let alone ring-fence funding for their recommendations.”

Professor Sir Michael Rawlins, the chairman of Nice, said that careful audits by the revamped Commission for Health Improvement might be needed to ensure that the agency’s rulings are followed across the health service.

Another senior Nice official, Anne-Toni Rogers, the director of corporate affairs, pointed out, however, that its rulings had proved effective in improving treatment for tens of thousands of patients. “After we recommended taxane treatment for breast cancer, usage went from one in five patients to three in four in just three months,” she said. “You have to ask whether 100 per cent take-up is possible.”

She said it was the Department of Health’s responsibility to ensure that the medicines it recommended for use were provided by health authorities.

A spokesman for the DoH said: “Where it comes to our attention that there is non-compliance with Nice guidance on drugs, this is raised with the strategic health authority concerned, who will need to sort it out at the local level with relevant NHS trusts and primary care trusts.

“We fully expect primary care trusts to meet their statutory obligations, and strategic health authorities to follow up any allegations of non-compliance.”

From:
Drugs-denied-to-sick-against-the-rules-of-new-NHS-watchdog.html

“This seems a rather bizarre decision and a low priority when there are much more serious issues facing the NHS over cancer treatment,” said Adrian Towse, director of the Office of Health Economics, which is financed by the pharmaceutical industry.

It became clear on Wednesday that the prime minister’s announcement had not been fully costed. The final bill would depend on which other long-term conditions were eventually included in the scheme, said the Department of Health, adding that it still expected to raise £150m-£200m a year out of the £400m in revenue that prescription charges currently generated in England.

Almost 90 per cent of prescriptions are dispensed free of charge. Those who pay but need drugs regularly can buy a pre-payment certificate, or “season ticket”, that covers all their drugs for £27.85 for three months – the cost of four prescriptions.

Andrew Lansley, the Conservative health spokesman, said it was “absurd” that the government was exempting cancer suffers from a maximum £100 a year bill for their medicines “while patients who could benefit from clinically effective cancer drugs that may extend their lives are being expected to pay out tens of thousands of pounds for their treatment”.

Mike Richards, the cancer czar, is compiling data and reviewing the policy on such “top-ups” to NHS treatment. But initial health department estimates are understood to indicate that it would cost the NHS between £100m and £300m a year to cover the cancer drugs that it currently refuses to fund.

That is a similar sum to the amount the government now plans to spend extending the exemption to prescription charges.

“It does seem rather odd to focus on the prescription charge rather than the much more serious issue of whether patients will get access to expensive drugs or will have to pay for them themselves,” Mr Towse said.

Alan Maynard, professor of health economics at York University, said given the problems that the government faced with the public finances, “this seems a very strange set of priorities”.

From:
http://www.ft.com/cms/s/0/c7c59448-8a7c-11dd-a76a-0000779fd18c.html?nclick_check=1