Trusts struggling with PFI debts

Ministers to send senior government lawyers and auditors to help seven trusts find savings and renegotiate contracts
courtesy of The Guardian 28 August 2012

Ministers said there was evidence that the NHS was not getting a fair share of savings that PFI deals were supposed to deliver. Photograph: Cate Gillon/Getty Images

Officials are to be sent to help seven hospital trusts unable to meet the repayments for their private finance schemes, ministers have announced.

Earlier this year the Department of Health said the hospital trusts were struggling with private finance initiative debts and would get £1.5bn in emergency funding to help them avoid cutting patient services to pay their bills.

The DoH now plans to send senior government lawyers and auditors to help the seven trusts find savings and renegotiate contracts.

The trusts involved are Barking, Havering and Redbridge; Dartford and Gravesham; Maidstone and Tunbridge Wells; North Cumbria; Peterborough and Stamford Hospitals; and St Helens and Knowsley NHS trusts, as well as the South London Healthcare Trust, which has been declared bankrupt by the department.

Many of the trusts targeted have had long-standing problems. The Barking trust has to find nearly £50m this year for its PFI deal agreed in January 2004; its financial commitments also led the Care Quality Commission to warn that the trust was failing to deliver proper standards of care.

Eyes on Evidence: August update

 Sleep apnoea may be an independent risk factor for deep vein thrombosis (DVT) but further research is required to confirm this.
Pharmacological thromboprophylaxis when used in addition to compression stockings does not reduce death rates, when compared with compression stockings alone. However, prophylaxis is still useful in reducing venous thromboembolism, unless there is a high risk of bleeding.

Risk of venous thromboembolism with non-oral hormonal contraception

An observational study suggests that women using the transdermal contraceptive patch or combined hormonal vaginal ring appear to have about twice the risk of venous thromboembolism compared with women using combined oral contraceptives containing levonorgestrel.

Dehydration in hospital-admitted stroke patients

Focusing on interventions to reduce the frequency and duration of dehydration have the potential to improve patient outcomes after stroke.

Long-term effects on renal function of tight glycaemic control in early type 1 diabetes

Long-term observational follow up of the Diabetes Control and Complications Trial shows that early tight control of blood glucose is associated with a lower risk of impaired renal function, but could not a detect a difference in the risk of severe renal impairment or end stage disease.
Evidence Updates

In the past month NICE has published online via NHS Evidence an Evidence Update on nocturnal enuresis.

Carolin Tonus, Markus Sellinger, Konrad Koss and Gero Neupert; World Journal of Gastroenterology; August 2012

This article “Faecal pyruvate kinase isoenzyme type M2 for colorectal cancer screening: A meta-analysis” by Carolin Tonus, Markus Sellinger, Konrad Koss and Gero Neupert was published earlier this month.
AIM: To present a critical discussion of the efficacy of the faecal pyruvate kinase isoenzyme type M2 (faecal M2-PK) test for colorectal cancer (CRC) screening based on the currently available studies.
METHODS: A literature search in PubMed and Embase was conducted using the following search terms: fecal Tumor M2-PK, faecal Tumour M2-PK, fecal M2-PK, faecal M2-PK, fecal pyruvate kinase, faecal pyruvate kinase, pyruvate kinase stool and M2-PK stool.
RESULTS:  Stool samples from 704 patients with CRC and from 11 412 healthy subjects have been investigated for faecal M2-PK concentrations in seventeen independent studies. The mean faecal M2-PK sensitivity was 80.3%; the specificity was 95.2%. Four studies compared faecal M2-PK head-to-head with guaiac-based faecal occult blood test (gFOBT). Faecal M2-PK demonstrated a sensitivity of 81.1%, whereas the gFOBT detected only 36.9% of the CRCs. Eight independent studies investigated the sensitivity of faecal M2-PK for adenoma (n = 554), with the following sensitivities: adenoma < 1 cm in diameter: 25%; adenoma > 1 cm: 44%; adenoma of unspecified diameter: 51%. In a direct comparison with gFOBT of adenoma > 1 cm in diameter, 47% tested positive with the faecal M2-PK test, whereas the gFOBT detected only 27%.
CONCLUSION: We recommend faecal M2-PK as a routine test for CRC screening. Faecal M2-PK closes a gap in clinical practice because it detects bleeding and non-bleeding tumors and adenoma with high sensitivity and specificity.

Newsletter for End of Life care

The National End of Life Care Programme newsletter has published its August newsletter.
From NHS Networks
The National Council for Palliative Care (NCPC) has launched a toolkit to empower local people to push for the right end of life care services following reform of the health and social care system.

Bowel cancer awareness campaign revisited

The Department of Health is launching a repeat of the national bowel cancer awareness campaign next week.
NHS Networks
The Department of Health has published the second national cancer patient experience survey based on feedback from 72,000 inpatient and day case cancer patients.

New unit at hospital

Published by The Buxton Advertiser on Saturday 25 August 2012

A NEW dedicated Breast and Gynaecology Unit is set to open at Macclesfield District General Hospital.

The new purpose-built unit, which opens on September 3, will provide high quality services for the diagnosis, screening and treatment of breast cancer and outpatient facilities for a wide range of gynaecology problems, with the latest equipment and techniques all under one roof.

There will be five consultation rooms, two rooms dedicated to digital mammography and a further two rooms for breast ultrasound in the new unit.

via New unit at hospital – Health – Buxton Advertiser.

WEBINAR: Developing and supporting telehealth in the NHS

When: 1pm-3pm,
4 September 2012

The NHS Confederation Business Development team are running a webinar on telehealth in the NHS on 4 September to discuss and resolve any issues and questions that were raised at the telehealth event at  the NHS Confederation’s annual conference on 21 June and to raise more awareness around the subject in a bid to improve overall patient care in the UK.

Dr. Shahid Ali, clinical lead patients and information directorate at the National Commissioning Board, will be speaking at the webinar.

Further details can be found on the NHS Confederation’s telehealth page, where you can book online to register for the event.

NEW Resources featuring ‘The Productive Series’

The Productive Series: Releasing Time to Care™ – is a programme developed by the NHS Institute for Innovation and Improvement to help front-line staff spend more time on patient care, reduce waste and improve efficiency. The Government aim to introduce the Productive Ward methodology into 100% of Acute, Mental Health, Community Hospital wards and Community Services teams by 31st March 2014. The Productive Series programmes have already been adopted by a high percentage of organisations and front line teams are using the tools and methodology to improve care, increase the time spent with patients, deliver process efficiencies and financial savings.

See for more information

NHS governor training programme to be launched

A new national programme to help foundation trust governors play their crucial roles to full effect will be launched in the new year.

The NHS foundation trust governor training and development programme will be open to the 2,600 governors across the country. As the number of foundation trusts (FTs) rises over the next few years the number of governors could triple.

This week the new NHS Leadership Academy awarded the contract for the national programme to the Foundation Trust Network (FTN).

via NHS governor training programme to be launched.

Autumn training options

The Staff Library offers training and support to staff and students through the following courses which are arranged at times and dates to suit individuals or small groups.  Our new course for the Autumn is An Introduction to Critical Appraisal Training.  However, if anyone requires assistance with creating a presentation, using the Internet safely, setting up an email or Athens account please contact us on 01625 66 3923.

Introduction to the Cochrane Library (1.5 hours)
This course aims to instruct staff in effective literature searching using the Cochrane Library and will cover keyword and MESH search, combining search terms, saving search histories and printing/saving results.

Introduction to NHS Evidence & Basic Literature Searching (2 hours)
This course is for staff who wish to learn the basics of literature searching using healthcare databases and will include a brief introduction to the NHS Evidence web portal. No previous experience necessary.

An Introduction to Critical Appraisal Training
We offer courses which examine critical appraisal of systematic reviews, randomised controlled trials (RCTs) or qualitative research. You will summarise the key features of the research type, identify tools to help appraise the research and carry out an appraisal of a relevant paper selected by the Library team. No previous experience is needed.

To book a place on any of the above courses or to discuss your requirements, please contact Library Staff on 01625 66 3923.

Transitions: Top tips for medical directors

from Leadership/Management by natalie.murray, 22 August 2012

The Faculty of Medical Leadership and Management has launched its Transitions series with top tips for medical directors. Based on the wisdom and insight of existing medical directors across the UK, Transitions: Medical Director is a unique resource designed to support doctors in leadership roles.

FMLM members can click Transitions: Medical Director to see the full guide. Non members can view helpfulextracts from Medical Director in our resource section.

‘Excellent piece of work; deja vu everywhere! A valuable collection of thoughts and wisdom to reflect on. Well done.’  Andy Kutarski, Medical Director, St Barnabas Hospice Trust

‘Very good (even essential) tips for medical directors’  Dermot O’Riordan, Medical Director, West Suffolk NHS Foundation Trust

Look out for further editions of Transitions in 2012:

  • College President
  • Clinical Director
  • New GP/Consultant
  • Medical Students
  • Female Leaders

via Google Reader

Weekly review from the Healthcare Network

Stories this week on the network include:

Meanwhile, Denis Campbell reported for the Guardian on research by the King’s Fund, which reveals the stark social class divide in health is widening. It found better-off people are increasingly shunning damaging habits such as smoking and eating badly but poorer people are not. The story says:

The findings have cast doubt on the prospect of the health secretary, Andrew Lansley, fulfilling his pledge to “improve the health of the poorest fastest” in order to reduce glaring health inequalities.

Here’s some other headlines from around the web this week:

… of the chief executives of the 10 largest NHS acute trusts in England (measured by staff numbers collected by the NHS Information Centre) nine are men, four have knighthoods, but – based on some searching, and happily subject to correction – only one appears to be active on Twitter. The exception that proves the rule is Dr Mark Newbold, chief executive of Birmingham’s Heart of England foundation trust, who has more than 1,300 followers. He also blogs: a post on 10 reasons why his peers should join him on Twitter cites openness, accessibility, learning from others and engagement with communities. On Twitter itself, Dr Newbold often uses his account to answer questions and engage in debate.

NHS staff could see cuts in pay and holidays – Public Service

23 August 2012

Staff at 20 NHS hospitals in the south west could see their wages reduced and their holiday entitlements cut to protect jobs, it has been claimed.

In a report, the South West Pay, Terms and Conditions Consortium (SWC) has suggested that if this action was taken in an average-sized hospital, around £9m a year could be saved. Cutting pay by 1 per cent could save £1.4m, making staff work another hour for no extra pay could save £2.6m and taking two days off people’s holiday entitlement could save £750,000.

via NHS staff could see cuts in pay and holidays – Public Service.