Monitor could be asked to examine £350m contract. A decision by NHS England to hand more than half of the country’s PET-CT imaging services to one company could be the subject of a formal complaint to market regulator Monitor, HSJ has learned. News of the potential complaint comes after the government was asked in the Commons to reassure MPs that no “undue influence” was brought to bear over the £350m contract. The decision in January to award all four regional lots to Alliance Medical sparked fears over the long term impact of the decision on competition. Concerns have also been expressed by another provider over the near “monopoly” Alliance Medical will have over the provision of PET-CT services in England for the next 10 years, as well as the majority control of production and supply of a radioactive drug known as FDG, which is vital to the PET-CT imaging process. HSJ understands Siemens Healthcare, which is the only other producer of FDG in England after Alliance took control of two other companies in 2013-14, is taking legal advice over the decision by NHS England. The company was not a bidder in the PET-CT imaging tender but could be heavily affected by NHS England’s decision.
Lancet condemns NHS for creating ‘culture of fear’ in wake of scandals. NHS reforms introduced following the disclosure of serious failings at the Mid-Staffordshire Trust have left staff feeling fearful of persecution, according to a respected medical journal. The stinging editorial in the Lancet criticises the NHS’ efforts to rebuild the reputation of the health service following a string of high profile scandals. The journal has taken the unusual step of publishing its own manifesto for health ahead of May’s general election. The article says: “The regulatory regime created in the aftermath of Bristol, Shipman, and most recently mid Staffordshire, has created a culture of blame, fear, and intimidation in the UK’s health system.” “Instead of regulation being a means to bring the best out of our health professionals, it is used as a tool to threaten, punish, and harm. The conditions we have created for health professionals in the NHS mean that few people are cherished. “Instead, they are seen as problems to be managed. An obsession with inspection has also blinded us from thinking about health as more than a health-sector issue.” The piece has been timed to create maximum impact ahead of the election, even carrying a distinctive ‘Election UK 2015’ logo, complete with a stylised ballot. An NHS England source said: “It’s a very interesting article. The bit that focusses on the regulatory regime, it’s the Government that sets that up. For us its business as usual, we deliver what’s set out by the Government. There should be an NHS voice in this. But as for why things are the way they are that’s Government policy.” The editorial calls for a more open-minded approach to the issues facing the NHS, demanding “immediate action to improve the interface between general and emergency medicine”, describing the current situation as “atrociously poor”.
Focus on targets in NHS poses threat to patient care, says thinktank. A “targets and terror” approach to ensure large hospital A&E departments in England treat, admit or discharge 95% of patients within four hours may undermine their care, a former senior NHS official has said. The micro-management culture within the NHS and Department of Health coupled with increasingly tight budgets will hasten the point at which entire urgent care system reaches breaking point, says Nigel Edwards, chief executive of the Nuffield Trust thinktank. Senior managers in hospitals are so busy collecting information on how they are doing each week to satisfy regulators, NHS bosses, health commissioners and politicians that they are not sorting problems on their own frontline, Edwards and two co-authors claim in a briefing paper. Major A&Es have not hit the 95% mark since summer 2013 despite all the attention paid to weekly figures in recent months, they say. But emphasis on the four-hour measure distorts the picture of how big hospitals are doing in the face of a 12% increase in attendances at their A&E units and a 27% increase in emergency admissions in a decade. The A&E rise is “entirely in line with what would be expected based on population growth”, according to the paper, which warns that 17,000 extra hospital beds could be needed by 2022 unless more could be done to treat people outside hospital. The NHS response was based “on the anxiety of the hierarchy rather than on the care of patients and the flow of patients through the system”, it said.
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Extra A&E funding didn’t reach the frontline. Only 1% of the £700m allocated by the government was spent on staff or other resources in their emergency departments. This is the key finding of research by the Royal College of Emergency Medicine which surveyed 142 clinical leaders in emergency medicine across the UK – representing about two thirds of emergency medicine units. Off the back of the survey, the college has released a report – called Ignoring the Prescription – which finds that implementation of recommendations to reduce the A&E crisis has been patchy at best. Last year, four medical royal colleges and many other organisations met to discuss how to make the urgent and emergency care system more resilient. Their report Acute and emergency care – prescribing the remedy was published in June and was welcomed by the NHS confederation and the Department of Health in England. But progress has been slow despite an additional cash injection of £700m. Less than half of EDs in the UK have fully implemented co-located primary care out-of-hours facilities. Less than a third of departments have an appropriate skill mix and workforce in place to deal with their patient volumes and case mix. It also finds that more than half of departments are not assisted by senior decision makers from in-patient teams at times of peak activity. The College concludes that a combination of failure to implement consensus recommendations coupled with the failure to invest allocated monies in frontline services has led to extraordinary winter pressures which were largely avoidable.
Sneaky way to privatise. Greater Manchester to control £6bn NHS budget – Greater Manchester is to become the first English region to get full control of its health spending, as part of an extension of devolved powers. Chancellor George Osborne said the £6bn health and social care budget would be taken over by the region’s councils and health groups. Mr Osborne said it was a “really exciting development”. A Labour spokesman said NHS workers would “want to be persuaded of the case for a new layer of management”. The plan will come into force from April 2016. Mr Osborne added: “This is what the NHS wants to see as part of its own future. And it’s also about giving people in Manchester greater control over their own affairs in that city, which is central to our vision of the ‘northern powerhouse’, so it’s a very exciting development.” The plan would see local leaders, and ultimately Greater Manchester’s new directly elected mayor, control how budgets are allocated. The government hopes integrating health and social care services will ease pressure on hospitals and help to improve home care services for patients who need it. A shadow Greater Manchester Health and Wellbeing board will be appointed, which will work closely with existing clinical commissioning groups of GPs. The board is expected to run from April, before control of the budget is handed over a year later. Manchester City Council confirmed 10 local authorities, 12 clinical commissioning groups, 14 NHS partners, NHS England and the government are in discussions on a “groundbreaking agreement for health and social care”. What will happen if Greater Manchester over-spends? And if this ‘Grandiose Plan for the NHS’ is extended to other parts of the UK, who will provide health care, should Greater Manchester, other Health Trusts run out of money? Therefore it begs the question, does it not, that I firmly believe is this – privatisation of the NHS by the back door by the Tory Party, and the only people to benefit will be NHS consultants, GPs and medical manufacturers; and also not forgetting MPs, who will, no doubt, have their snouts in the trough with ‘interested parties’. Therefore, may I respectfully suggest that if David Cameron MP is elected Prime Minister in May will he please confirm his Electoral Pledge of many years ago – ‘that the NHS is totally safe in Tory hands’.