Posts Tagged ‘Reforms’

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QIPP lead urges NHS reorganisation

Wednesday, June 15th, 2011
The Department of Health’s clinical lead on the Quality, Innovation, Productivity and Prevention (QIPP) programme has asserted that it is essential that the NHS look to reform around long-term conditions.

Speaking at the Guardian News & Media’s Smart Healthcare Live conference in London,
John Oldham asserted in his speech that health service will not be sustainable without significant reorganisation. He said that the largest burden will be that the NHS will have to cope with the tripling of patients with multiple long-term conditions by 2050, which will require significant consideration given to preventative measures.

Oldham said that being adequately prepared will mean the NHS will have to integrate health and social care provision, saying that disease-specific strategies on their own are a redundant strategy for the future. He explained that the NHS needs to improve its risk profiling of patients and establish integrated care teams at a local level, as the current model for dealing with multiple conditions segments a person by body part as opposed to taking an comprehensive view of the patient as a whole.

He said that one of the best ways of integrating healthcare was to improve information for patients and clinicians with better access to Electronic Patient Records (EPR) as a method of integrating health records.

“Conveying knowledge to patients, who are the most undervalued resource in our system, is key to managing long-term conditions,” Oldham told the event. This has been shown to significantly influence outcomes, such as greatly reduced mortality rates.

Other simple solutions he cites is the use of technology such as one NHS trust in the North of England which has patients submit their blood pressure readings using a pay-as-you-go mobile phone. Oldham also believes that Telehealth could play a significant part in treating long-term conditions, but urges Trusts to consider changing their working practises before utilising such a system.

He also warned that introducing Telehealth must lead to savings elsewhere in the system such as fewer home visits by healthcare professionals, implying that some consideration should be given to where savings can be recouped.

As a long term strategy, Trusts could seek to implement an EPR system as a technology solution that makes patient records available across all Therapies to lead to better integrated care. Therapy Manager is such a system that can also lead to reduced clinical and administrative input to potentially increase capacity and highlight exactly where savings can be recouped and financial cutbacks incurred.

Original Source The Guardian

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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Health reforms to be relaunched

Tuesday, June 14th, 2011
Following the “pause” in the Health and Social Care Bill, David Cameron will unveil wholesale changes to the controversial NHS reforms before they are to be relaunched.

The Bill was paused following an independent review which criticised many of its key proposals, with plans to increase competition and grant GP’s control of commissioning being opposed by NHS staff and many Liberal Democrats.

Following the 10-week “listening exercise” which effectively paused implementation of the Bill, a panel of experts called the NHS Future Forum gave its recommendations on the changes required.

Revisions to the Bill mean that large-scale change within the NHS is now expected to occur at a slower pace and in addition, hospital doctors and nurses will play a greater role on commissioning boards, ensuring they will be comprised of a wider network of healthcare professionals other than just GP’s. Amongst the changes include a relaxation of the 2013 deadline for the new GP commissioning arrangements to be finalised and as previously mentioned, a greater role for other healthcare professionals in consortia whom along with GP’s will be accountable for 65% of the NHS budget. Furthermore, the power of council-implemented health and well-being boards will be increased, and patients given a greater role on them.

With regards to competition, one of the most controversial aspects of the reforms, the focus will be “significantly diluted”. The economic regulator Monitor will shift their focus away from competition and on improving patient choice instead, although competition will still have an important role to play in the future NHS.

The NHS Future Forum, which has spent two months analysing the reforms, said yesterday that the Government’s plan must undergo significant changes. Its chairman, Professor Steve Field, former head of the Royal College of GPs, said that the principles underlying the Bill which include devolving control to clinicians, giving patients greater choice and increased focus on outcomes are well supported, although they are mindful of the concerns from NHS staff, patients and the public. He asserts these must first be addressed if the reforms are to be successfully progressed.

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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Reforms should be outcome focused

Tuesday, May 31st, 2011
A professor at the University of Oxford is urging the population to question the reforms outlined in the Health and Social Care Bill, and consider whether they will actually increase the quality of care provided by the NHS.

David Kerr, Professor of Cancer Medicine at the Nuffield Department of Clinical and Laboratory Sciences, University of Oxford has asserted that recent history suggests that there have been several well-documented and serious lapses of care. He says that whilst the performance of the NHS is improving, the UK is behind in reporting it’s clinical outcomes in comparison with it’s European counterparts. Furthermore the variation in these outcomes when comparing the best and worst performing clinical teams in the UK is rarely debated.

Kerr believes that thousands of lives could be saved every year if the spread in outcome figures were reduced. Currently, there are a number of elements contributing towards this variation which are dependent on inequalities in the health system. He cites disparities in clinical knowledge, poor allocation of resources and organisation and insufficient access to appropriate care specifically as domains which should be the focus of reform in a quality-driven NHS in order to reduce variation.

He asserts that the most rapid improvement in outcomes will come as a result of adopting clinical outcomes as a truer means of assessing the quality of NHS care in conjunction with an information revolution that promises to make this clinical data public.

By publishing outcome data, patients will have the ability to monitor performance improvements within local health communities. Kerr expects that the dominant performance driver however will be professional peer pressure, as this information will allow national benchmarking of clinical teams.

Particular care should also be given to subjective measurements of care, such as Patient Reported Outcome Measures (PROMs) as opposed to broad objective considerations. PROMs aim to generate subjective evaluation of services by patients and carers, posing a set of simple but informative questions.

‘The NHS is data rich but information poor, and this must be addressed in the Bill’ he says.

In order to ensure that outcome data is consistently and accurately captured as a product of streamlining clinical activity, Trusts may seek to implement an Electronic Patient Record (EPR) system. Therapy Manager is an EPR provides a simple mechanism to capture and audit subjective and objective outcomes versus a number of clinical and activity parameters captured during the patient journey which can validate the contribution of Therapies towards patient care.

Original Source The Telegraph

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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Fears over the cost of health reforms

Thursday, May 26th, 2011
The Commons Public Accounts  Committee (PAC) has voiced concerns that the government’s plans to turn every hospital into a freestanding business could lead to large amounts of money being wasted.

As outlined in the Health and Social Care bill, the coalition has set a target for all hospitals to become NHS foundation trusts by 2014. In addition, the Department of Health (DoH) has set a target of £1.2 billion worth of savings on procurement as part of its goal to raise £20 billion in efficiency gains.

The parliamentary spending watchdog has warned that there is no way to ensure that hospitals will co-operate to reduce the £4.6 billion annual spend on goods ranging from beds to surgical gloves as a method to contributed towards these savings.

The PAC’s warning follows a National Audit Office (NAO) report which demonstrated a large variations in prices for the same products and a national failure to standardise purchases. The report found that the NHS had been buying 652 types of surgical gloves and 1,751 different types of cannula all at different prices.

Chairman of the PAC, Margaret Hodge, said the health department was proposing a three-tiered structure to improve purchasing, with different types of products bought at local, regional and national levels. She stated that this did not however reflect the current complexity of procurement, in which a large number of different bodies are involved and where in a number of cases, prices of products available through the NHS supply chain can be higher than through other routes.

The PAC have stated that in the current climate, the DoH has failed clarify how, trusts will be motivated to deliver collectively the on their savings targets. They also assert that the DoH should provide some steer as to who should be accountable when money and resources are unnecessarily wasted by paying more than necessary on everyday products.

With “no explicit incentive” for hospitals to co-operate, the committee warn that the situation could worsen when half of the hospitals that were not already foundation trusts attained that status. “Getting this system right is critical to improving procurement performance in the future,” the committee said.

The NAO has previously estimated that by standardising purchasing and by aggregating small orders, the NHS can save £500m annually – the budget of a larger district general hospital.

In areas such as Orthotics where large amounts of equipment are ordered on a daily basis, it has been suggested that orders and suppliers could be consolidated as a method to effectively cut costs. Hospitals attaining foundation trust status could look to implement Therapy Manager, an Electronic Patient Record (EPR) system which provides the mechanism to capture orders by supplier, equipment type and category so that buyers can enter into informed negotiations with suppliers and potentially reduce spending.

Original Source Financial Times

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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Concerns over ‘risky’ reforms

Wednesday, April 27th, 2011
The Commons’ Public Accounts Committee (PAC) has warned that the “risky” reorganisation of the NHS could potentially distract from the imperative for the health service to recoup £20 billion in savings over the next four years.

It has also warned that the Department of Health’s (DoH) £1.4 million estimate of the cost of the reforms could become inaccurate if GP commissioning consortia decide not to employ significant numbers of primary care trust staff, and instead purchase commissioning support from the private sector. If these perceived one-off costs associated with reorganisation turn out to have been underestimated, it will exacerbate the challenge of achieving savings for reinvestment.

As it is unusual for the PAC to take such an early look at a major reform programme, it is the scale of the changes and health service spending which has made the committee decide to review progress at regular intervals.

The reforms will remove strategic health authorities and primary care trusts, and hand commissioning to a powerful new NHS Commissioning Board and GP commissioning consortia. At the same time, they will introduce more competition for providers, although the landscape review warns that it is still not clear where accountability for public money will lie in the new structure.

It has been previously been reported that 20 trusts may fail to achieve foundation status, and that increased competition may lead others to fail. Furthermore, it is believed that the Department of Health has yet to develop clear and transparent policies for dealing with failure of commissioners or providers which would ensure that patients are protected and value for money assured.

Dr Hamish Meldrum, chairman of council at the British Medical Association believes it to be extremely important that the PAC highlights the risks posed by drastic restructuring under the current financial climate.

Under the currently paused health reforms, the DoH expects 40% of the required savings to come from pay freezes, management cost savings and cuts in central budgets, and another 40% to come from encouraging providers to become more efficient by pegging the NHS tariff to the most efficient trusts.

A further 20% are due to come from service changes, such as shifting services from hospitals into the community. The PAC are urging the DoH to monitor progress against this target, over which they believe it has little control.

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 Commissioning | No Comments »

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