The Health & Social Care Information Centre’s recent report on Written Complaints in the NHS – 2014-15 makes interesting reading apart from the repeated disclaimer: ” We are unable to provide comparisons with previous years”. In response to the report the NHS Federation (representing senior managers) said: “A higher number of patient complaints may be received by Trusts as we see an even greater open dialogue between the NHS and patients.” Maybe, but how could we tell from HSCIC data? How are we to make any sense of this kind of information without seeing the trend over time? It makes Health Matters wonder why the report was released at all.
There is a shortage of nurses in general practice, so when a South London group practice found one, they employed her immediately. She had been a district nurse, then a practice nurse, before taking a break. The practice wanted to deploy her to start the annual ‘flu vaccination campaign, but the CCG demanded evidence that she could give intra-muscular injections. Wasn’t her career to date enough evidence, said the practice innocently. No said the CCG, evidence of past skills was not evidence of current ones, she must go on a refresher course and get a certificate. There is a waiting list for the course, so the practice must wait. Being entrepreneurial the practice is teaching senior medical students how to give flu jabs, as part of their clinical training. The CCG cannot interfere with professional education, yet.
Talking of CCGs, a North London example is having its governance procedures reviewed after a whistle-blower piped up about the shambolic running of the organisation, its autocratic leadership and the sense of intimidation in the area. Health Matters will keep you informed.
The ‘preferred provider’ is making a comeback, if the HSJ is to be believed (26th August 2015). Monitor had announced that “Northern, Eastern and Western Devon Clinical Commissioning Group did not break procurement regulations when it selected a preferred provider for a £100m community services contract without going to tender”. The competition was between Royal Devon and Exeter Foundation Trust (the challenger) and the current provider, Northern Devon Healthcare Trust. Allegations of conflicted interest and opacity were made, but Monitor approved the process, creating a precedent for not going out to tender. Do we now have a loophole for CCGs to keep the private sector out? We shall see.
The HSJ reported (28th August 2015) that more than 2,100 mental health patients needing hospital admission were placed in-patient beds out of their area in May of this year. Not a happy state of affairs, but Health Matters notes that on Wednesday 26th August there were no forensic psychiatric beds available in either the NHS or the private sector in the South of England. That’s mentally ill people with a history of violence we are talking about.
Volunteers are important people for the NHS, as for all of civil society, but recruiting and retaining them is not easy – some say it is getting harder. A recently published study shows that whilst big centralised command-control charities (like RNIB) can successfully grow and sustain intervention programmes at scale, there are a number of factors which mean local franchises of devolved-model charities are unlikely to be able to do so. This is useful information for anyone who believes that large-scale public services can’t be replaced by volunteer provision. Check out: http://www.journalslibrary.nihr.ac.uk/__data/assets/pdf_file/0019/131176/FullReport-phr02070.pdf
Sir Robert Naylor is leaving University College London Hospital Trust. He helped develop the Foundation Trust model as part of Labour health secretary Alan Milburn’s strategy team in the mid noughties. Now he says Foundation Trust’s have to go, and the NHS needs a dose of “co-operative and collaborative skills.”(HSJ September 1st) He added: “The whole tariff situation is no longer fit for purpose, and that’s been compounded by the fact you’ve got all these hospitals making a deficit and they’ve been given handouts,” “It’s hardly surprising that trusts now are aiming to make a deficit because if you make a surplus, then what would happen? They’d take the money away from us, so what’s the point?” Oh dear, trouble in the managed market.