Self governing NHS hospitals – known as foundation trusts – have had their private income capped to date, but this is to be lifted in the NHS overhaul.
The Foundation Trust Network believes the move will spark a burst of innovation in the sector.  But campaigners said they were worried NHS services would be harmed.

To get foundation trust legislation through parliament in 2003, ministers agreed to a cap on private work to ensure the hospitals remained true to their NHS traditions.

This has stopped some of the leading hospitals in the NHS competing with private firms for patients.

But that will now change under the proposals unveiled in Monday’s white paper. Health Secretary Andrew Lansley said he wanted to create a “vibrant” industry of social enterprises by scrapping the rule and ordering all NHS trusts to become foundation trusts within three years.

Sue Slipman, director of the Foundation Trust Network, said the move would make a big difference.

“It is exciting for foundation trusts. We will have to wait to see what exactly happens, but there are huge opportunities to innovate.”

She said one of the most obvious areas for expansion would be in fertility services where treatment on the NHS is severely restricted.

“In the past these patients have had their NHS cycles and then left for private treatment. That is money that has been lost to the system.”

She also said mental health trusts may be interested in offering talking therapies to businesses for their workforce health schemes.

University College Hospital in London has already gone down this route with a private US health firm which has located a private unit on its site for cancer treatment.

The firm leases the space as well as paying for the NHS services it uses, such as intensive care, radiology and cleaning and catering.

The trust has also established a joint venture with a private firm to provide pathology services.

Sir Robert Naylor, the chief executive of the trust, said: “These initiatives bring in money which can then be reinvested in NHS services.”

Many NHS hospitals also operate their own private wings, although most of these only bring in a small amount of income. The exceptions are specialist centres such as the Royal Marsden cancer hospitals and Moorfield Eye Hospital.

But John Lister, of the union-funded pressure group Health Emergency, said he had concerns.

“Hospitals could overstretch themselves in chasing private patients which in turn takes away from the NHS side of it.  It also creates perverse incentives whereby they stand to make more money by getting patients into their private wings.

“They say money is reinvested in services, but I am not sure this is always the case. Some of these hospitals have huge surpluses, the money is moved around and does not end back where it should. If we get more and more of this, it will be a step towards the privatisation of the health service.”

From: http://www.bbc.co.uk/news/10619463

Women should be tested for chlamydia every time they have a new sexual partner to cut their chances of pelvic disease, UK researchers say.

A study of 2,500 students found that annual screening is not enough to prevent cases of pelvic inflammatory disease, which can cause infertility.

In those who were found to have chlamydia, treatment cut the risk of pelvic disease by 80%.

The National Chlamydia Screening Programme backed the findings.

The researchers from St George’s, University of London, concluded that most cases of pelvic inflammatory disease were in women who did not have chlamydia when they were tested a year earlier.

The findings, published in the British Medical Journal, suggested they may have become infected in the 12 months after screening.

Chlamydia is the most common sexually transmitted disease in the UK and the number of cases is steadily rising.

The researchers recruited sexually active female students between the ages of 16 to 27 from 20 universities and colleges in London.

They were swabbed at the beginning of the study and tested for pelvic inflammatory disease, which as well as infertility can cause chronic pain and increase the risk of ectopic pregnancy, a year later.

The researchers found that most cases of pelvic inflammatory disease occurred in women who tested negative for chlamydia when they were initially tested.

Study leader Professor Pippa Oakeshott, who also works as a GP, said: “The crucial message is that individuals should get tested every time they have a new sexual partner.”

But she added that chlamydia was not the only cause of pelvic inflammatory disease.

“It’s probably several bacteria that cause it, and we should probably be screening for other things, but chlamydia and gonorrhoea is a good start.”

She also said testing needed to be more accessible to young people, with kits being given out in colleges and youth clubs.

A spokesman for the Health Protection Agency said the findings reinforced the testing policy of the National Chlamydia Screening Programme, which was launched in 2003.

“The study, looking at a single annual test, shows the importance of the programme’s approach to testing annually or on change of sexual partner because most cases of pelvic inflammatory disease occurred in women who initially tested negative for chlamydia.”

Last year the National Audit Office criticised the screening programme for duplicating effort and failing to test as many of the under-25 target group in England as it should have.

From: http://news.bbc.co.uk/1/hi/health/8609354.stm

The rising rate of blunders in IVF treatment ‘may be systemic’, says leading patient safety expert

The number of reported mistakes a t the 138 fertility clinics in England and Wales nearly doubled in the year to April 2009, rising to 334 from 182 the previous year. One leading patient safety expert has now warned that blunders which have occurred as record numbers of women seek treatment, may be “systemic”.

The increase comes as one clinic, IVF Wales, is at the centre of a fresh scandal after losing the last two remaining embryos it had frozen for one of its patients. It is the second time in less than 12 months that a mix up at the centre, based at University Hospital of Wales in Cardiff, has left patients devastated.

The Cardiff-based couple has had their eight-year quest to have a baby put on hold as a result of the blunder, which followed an initial, unsuccessful course of IVF. The pair, identified only as Clare and Gareth, are suing Cardiff and Vale University Health Board, which last year paid out a five-figure sum in compensation for negligence after another mix up.

Guy Forster, a solicitor at the law firm Irwin Mitchell who is representing the couple, said the incident raised questions about the Government’s IVF watchdog, the Human Fertilisation and Embryology Authority.

“This raises concerns about the HFEA’s ability to regulate the IVF industry properly. I think it should be doing a lot more to follow up when an incident occurs, especially at a clinic with a poor track record,” he said, adding: “These problems appear to be on the rise.”

An official review last year found that the HFEA was failing to punish badly run fertility clinics by not using the “full range of sanctions” at its disposal. Professor Brian Toft, a patient safety expert at Coventry University, said: “If the HFEA fails to clamp down when something has gone wrong then things will continue to go wrong.”

He said the rise in reported incidents, uncovered by BBC Radio 5 Live, implied clinics were not learning from their mistakes, adding: “I have been told there are not enough qualified staff doing the work. HFEA do not make any recommendations for staffing levels per number of patients. If you have a lot of patients and not enough staff, this could account for an increase in errors. This problem may well be systemic.”

Professor Sammy Lee, an IVF expert, said the watchdog must ensure clinics comply with regulations. “They need to obtain staff that have experience of enforcement and are able to make sure that regulations are put into place,” he said.

An HFEA spokesman played down the increase in blunders, which he said was partly due to new rules requiring clinics to include incidents when patients suffered from ovarian hyperstimulation syndrome (OHSS). “The number of reported incidents has increased as the sector has responded positively to the opportunity to share lessons learned from incidents which have been reviewed and investigated,” the HFEA added in a statement.

From: http://www.independent.co.uk/errors-at-ivf-fertility-clinics-double-in-just-one-year