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NHS savings “unsustainable” says NAO report

Friday, January 11th, 2013

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A recent report has warned that efficiency savings made in 2012 by the NHS are “unsustainable”, and possibly threaten efforts to reach savings targets set out by the Department of Health (DoH).

The “Progress in Making NHS Efficiency Savings” report from the “National Audit Office” (NAO) states that the savings so far have been the easiest to make, and that these levels are not sustainable. The NAO assert that these savings have been made through pay freezes for public sector staff and reductions in the prices primary care trusts pay for healthcare services.

The “Nicholson Challenge” sees the NHS attempting to reach £20 billion in efficiency savings by 2015. Directives from the government assert that these savings should be accrued from sustainable sources, and not simply one-off cuts and staff redundancies. The research suggests that £520 million of the reported savings for 2011/12 were one-off in nature, with the NHS having to find replacement savings in future years.

There is also criticism of the reporting process through which trusts currently provide evidence of financial performance, with the NAO only able to substantiate £3.4billion worth of savings, compared to the DoH’s claim of £5.8 billion during 2011/12.

It is thought that the transformation of services is the greatest opportunity for savings, but that Trusts have been slow to consider this option.

Ayas Morse, Head of the NAO, said “to build on these savings and to keep pace with the growing demand for healthcare, it will need to change the way health services are provided and do so more quickly.”

To address these issues, the report makes the following recommendations:

  • The DoH should take a more active interest in demand management and develop ways of gaining routine assurance that patients’ access to healthcare is not being inappropriately restricted
  • The DoH and the NHS Commissioning Board should work with the NHS to reduce barriers to transforming services and to evaluate the impact of transformational initiatives as they are implemented to generate evidence about what works locally and on a larger scale to encourage the NHS to apply good practice more widely
  • In developing future mechanisms for paying for healthcare, the DoH, Monitor and the NHS Commissioning Board should consider how these mechanisms can be used to drive service transformation and care that is integrated around the patient
  • The DoH should develop better ways of monitoring progress on service transformation
  • The DoH should provide better guidance to the NHS on how to measure and report efficiency savings so that the total savings reported are more strongly supported by robust data
  • The DoH should improve transparency by making clear any caveats to data quality when it reports efficiency savings

Original Source Building Better Healthcare

About Pathway Software

Pathway Software (www.pathwaysoftware.com) specialises in the design and development of patient information systems for Allied Health professionals.

Its flagship product, Therapy Manager, is an Electronic Patient Record (EPR) system specifically designed for Therapy Services to provide decision makers with the ability to track and manage clinical activity and analyse cost of care by patient, episode or service. The system also demonstrably reduces administration time and the costs of managing Therapy Services.

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Huge Savings from Smart Procurement

Tuesday, September 27th, 2011

The government has stated their hopes that smarter procurement could help the NHS in England to save more than £15 billion over the next three years.

Ministers are urging Trusts to use common sense to save between £15 and £20 billion from the NHS budget in England over the next three years, with at least £1.2 billion expected to come from the hospital procurement budget.

Examples are already being seen across a number of Trusts, such as Barts and the London NHS Trust saving £320,000 a year just by changing its order for examination gloves. Previously, over 20 different types were purchased, totalling £700,000 a year. Limiting choice and restricting purchasing to just one supplier has enabled the procurement team to make the savings by standardising to a better value product.

There are concerns however arising from the fact that by 2014 nearly all hospitals will be run as independent Foundation Trusts, meaning that ministers will have little direct control over their spending priorities.

The findings support a previous National Audit Office (NAO) report which found that there is already a lack of standardisation and bulk buying by NHS trusts when it comes to the everyday consumables that fuel a hospital including paper, rubber gloves, canulas and plastic tubing.
It was found that Trusts bought 21 different types of A4 paper, 652 different types of rubber gloves and over 1,700 different cannulas.

Hospitals are also paying a wide range of different prices for exactly the same item, with some paying 50% more than the best performers. It is estimated that approximately £500 million is being lost every year on £4.6 billion spending, which could be better directed towards other services.

Health minister Simon Burns insists that the waste must stop, and Trusts must introduce greater transparency into the system to get better practice and for Trusts to look more at how they can bulk purchase. A number of Trusts in London are already successfully collaborating with other trusts in England to compare prices and reduce costs.

Burns insists that the impetus to improve must come from the Trusts themselves, as they are all independent organisations. He states the importance that Trusts get the freedom to be able to make the commercial decisions that they believe are right for their community including the products that they buy. The decision to make procurement practices more efficient need to be recognized at a Trust board level, and Burns asserted that the government was working towards developing standards for good procurement so that they can be understood and brought in throughout the organisation.

Through more efficient buying procedures, hospitals start to consolidate orders and suppliers, particularly in areas like Orthotics where large amounts of equipment are ordered on a daily basis in order to curb spending. To support this, Trusts could seek to use Therapy Manager, an Electronic Patient Record (EPR) system which provides a mechanism to capture orders by supplier, equipment type and category. With accurate real-time data surrounding expenditure available at managers fingertips, buyers will be able enter into informed negotiations with suppliers to ensure the best value for money.

Original Source BBC News

About Pathway Software

Pathway Software (www.pathwaysoftware.com) specialises in the design and development of patient information systems for Allied Health professionals.

Its flagship product, Therapy Manager, is an Electronic Patient Record (EPR) system specifically designed for Therapy Services to provide decision makers with the ability to track and manage clinical activity and analyse cost of care by patient, episode or service. The system also demonstrably reduces administration time and the costs of managing Therapy Services.

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NHS IT plan set for Autumn reveal

Monday, August 8th, 2011

The Department of Health (DoH) has revealed that it hopes to unveil a new structure for NHS IT which will be published in “the autumn”.

A DoH spokesperson has confirmed an announcement will shortly be made concerning the future of informatics within the health service and the form it will take to support the changing NHS. It is revealed that the announcement will also include “insights” from the Cabinet Office’s Major Projects Authority review of the National Programme for IT (NPfIT) in the NHS, which was triggered by the National Audit Office’s (NAO) latest investigation into the programme.

This follows moves taken by the DoH earlier this year to meet with NHS IT staff in Trusts, Primary Care Trusts (PCT’s) and health informatics services to gather views about the structures and support that will be needed in the reformed NHS.

Christine Connelly, former Director General of Informatics, indicated that a four tier structure might emerge under the reforms. The provisionally named “Health Informatics England”, a national shared informatics organisation, is thought to sit at the top which will hold NPfIT contracts. Connelly informed the Commons’ Public Accounts Committee (PAC) that such a body might be essential as strategic health authorities will cease to exist by the time the contracts expire in 2015-16.

It seems likely that a transitional body, similar to NHS Connecting for Health, will be set up as an interim step to enable the safe transit of the contracts. This should occur until such a point that individual organisations are able to take responsibility as currently they represent sums too great for individual Trusts to handle.

A report by the PAC expresses considerable concern about the future of NHS IT, stating that Trusts need urgent clarity on the state of current NPfIT contracts and the costs that will be incurred as a result of keeping or moving away from NPfIT systems.

The PAC are urging the DoH to communicate with every Trust to clearly outline the detailed implications of their future responsibilities for care record systems, focusing in particular on the “financial liability to which each Trust will be exposed”. They assert that this should also indicate the exit costs from current NPfIT contracts in addition to future maintenance and running costs for those Trusts that continue with systems implemented by the programme.

Furthermore, the PAC also want the DoH to specify the support it will provide for Trusts procuring non-NPfIT systems “where such systems can be shown to represent value for money to the NHS or greater functionality.”

In this light, Trusts may increasingly have the ability to allocate their own budget into truly relevant areas and seek out smaller and more tailored solutions which deliver on specific requirements. They may therefore look to implement an Electronic Patient Record (EPR) system such as Therapy Manager, which is highly focused on efficiently capturing and reporting on clinical activity within Therapies. It can also be seamlessly integrated with the majority of Trust-wide solutions and Therapies-specific applications.

Original Source eHealth Insider

About Pathway Software

Pathway Software (www.pathwaysoftware.com) specialises in the design and development of patient information systems for Allied Health professionals.

Its flagship product, Therapy Manager, is an Electronic Patient Record (EPR) system specifically designed for Therapy Services to provide decision makers with the ability to track and manage clinical activity and analyse cost of care by patient, episode or service. The system also demonstrably reduces administration time and the costs of managing Therapy Services.

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PAC warns against renewing CSC contract

Friday, August 5th, 2011

The Commons’ Public Accounts Committee (PAC) has warned the government not to let the Department of Health (DoH) award a new contract to CSC on the grounds that it would grant the company “an effective monopoly” in the North Midlands and East of England.

The recent report published by the PAC examined the National Audit Office’s (NAO) investigation of the delivery of detailed care records by the National Programme for IT (NPfIT) in the NHS. It stated CSC has failed to meet a number of deadlines and commitments, placing the blame primarily on inadequate project management.

Margaret Hodge MP, chair of the PAC, asserts that the DoH should now undergo an urgent review to discern whether to continue with the remaining elements of the care records system. It is estimated that the remaining spend allocated to the project stands at £4.3 billion, and Hodge believes that this could be better used to implement “systems that are proven to work, that are good value for money and which deliver demonstrable benefits to the NHS.”

It has been revealed that there have been major delays in the North, Midlands and East of England with the NPfIT, where just 10 of 166 trusts have received only the most basic Lorenzo system. Furthermore, it appears that no systems have yet been successfully delivered into mental health Trusts. Instead of providing contracted systems, it appears that CSC has implemented ‘interim’ alternatives which had originally been rejected when contracts were first awarded to the company.

Rather than holding CSC to its contract commitments, the DoH is instead planning to award a deal that would enable it to offer older software to a much smaller number of NHS trusts.

MP Richard Bacon, who triggered the latest NAO investigation, asserted that the DoH was unable to demonstrate what has currently been achieved for the £2.7 billion spent so far.

A DoH spokesperson has admitted that following the failures, the government now recognises the weaknesses of a top-down, centrally-imposed IT system. The DoH has since reduced spending on NHS IT programme by £1.3 billion, and hope that by engaging with the NHS they will be able to ensure it delivers greater benefits for patients.

“We are determined to deliver even more value for money from the programme. The findings of the Public Accounts Committee, alongside the outcome of the Major Project Review Authority, will contribute to the planning currently underway for future informatics support to the modernised NHS.”

With the climate in the NHS moved away from large and all-encompassing IT systems, Trusts may increasingly have the ability to allocate their own budget into truely relevant areas and seek out smaller and more tailored solutions. With this in mind, Trusts could look to implement an Electronic Patient Record (EPR) system such as Therapy Manager, which is highly focused on efficiently capturing and reporting on clinical activity within Therapies. It can also be seamlessly integrated with the majority of Trust-wide solutions and Therapies-specific applications.

Original Source eHealth Insider

About Pathway Software

Pathway Software (www.pathwaysoftware.com) specialises in the design and development of patient information systems for Allied Health professionals.

Its flagship product, Therapy Manager, is an Electronic Patient Record (EPR) system specifically designed for Therapy Services to provide decision makers with the ability to track and manage clinical activity and analyse cost of care by patient, episode or service. The system also demonstrably reduces administration time and the costs of managing Therapy Services.

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Posted in NPfIT | No Comments »

PASC Criticises Government IT Failures

Friday, July 29th, 2011
The Commons’ Public Administration Committee (PASC) has voiced it’s concerns over the lack of governmental IT skills and systems, additionally labelling their over-reliance on a few large contractors as a “recipe for rip-offs”.

A report published by the committee comments on the government’s ongoing record of developing and implementing, calling it “appalling” despite being funded by what it labels as an “obscene” amount of public spending.

This echoes the findings of a number of spending watchdog investigations into government IT. Whilst not directly referencing the latest National Audit Office verdict on the National Programme for IT in the NHS, both came to the conclusion that large scale IT procurement has often resulted in late and over budget IT systems that are not fit for purpose.

Bernard Jenkin, Chair of the PASC, states that the government consistently relies on an “oligopoly” of a few large suppliers, which is one of the contributing factors to these project failures.

In reviewing 30 major cross-government policies, reviews and strategies of IT from 2000 to 2010 examined previously examined by the NAO, the PASC found a number of common problems across these projects. Mostly, projects were too large, open to only a limited range of suppliers; and duplicating work that had already been done elsewhere. Furthermore, it was found that these systems were not interoperable with each other or any existing IT systems, and failed as a result of poor management and lack of user engagement.

As a result of large-scale project failures and missed deadlines by a number of large providers, the government has taken a number of measured to try to address these problems. For example, a presumption has been created against projects having a lifetime value of more than £100m. An asset register has also been created along with a cross-public sector app store, promotion of open source software and promotion of open standards.

The PASC says however that it believes that the government has not yet “grasped the fundamental causes of failure or simply listed it’s systems.”

The committee asserts that the failure of many IT projects may instead be a symptom of a more deep-rooted tendency for departments to think about policy and IT in isolation from each other. They also state that reluctance amongst different departments to work together may have lead to over-capacity in data centres and a lack of cross-public sector contracts.

To fully understand the root and implications of these IT problems, it is recommended that the government urgently reviews it’s actual and predicted spend on IT goods and services, and also publish more information about current systems and costs. “All IT procurement contracts should be published in full to ensure transparency and restore trust,” it says.

The report also calls for a wider supplier base, saying smaller contracts, common standards, and procurement changes are needed to encourage input from small and medium sized enterprises.

With reduced government backing, the NPfIT will become more optional for Trusts, granting them the ability to allocate their own budget into relevant areas and smaller, tailored solutions. With this in mind, Trust’s could look to implement an Electronic Patient Record (EPR) system such as Therapy Manager, which is highly focused on efficiently capturing and reporting on clinical activity within Therapies. It can also be seamlessly integrated with the majority of Trust-wide solutions and Therapies-specific applications.

Original Source eHealth Insider

About Pathway Software

Pathway Software (www.pathwaysoftware.com) specialises in the design and development of patient information systems for Allied Health professionals.

Its flagship product, Therapy Manager, is an Electronic Patient Record (EPR) system specifically designed for Therapy Services to provide decision makers with the ability to track and manage clinical activity and analyse cost of care by patient, episode or service. The system also demonstrably reduces administration time and the costs of managing Therapy Services.

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Posted in NPfIT | No Comments »

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