CQC and Local Government Ombudsman to Share Concerns About Care Service Providers

The CQC and Local Government Ombudsman have announced a new Information Sharing Agreement which will see the seamless sharing of information about poorly performing care providers, to support both organisation’s work in regulating this sector and members of the public reporting concerns.

The agreement (known as an Information Sharing Agreement (ISA)) gives details of the principles both organisations will follow when sharing information about complaints and concerns. The organisations have agreed to work closer together, including further development of the ‘warm transfer’ of calls systems between the organisations.

‘Warm transfers’ will allow the CQC’s National Customer Service Centre to directly transfer complaints about adult social care to the LGO whilst the complainant is still on the same call. The LGO can also transfer calls to CQC where the complainant wishes to share that information.

The LGO looks at complaints about councils and some other authorities and organisations, such as adult social care providers (including care homes and home care providers). Their role is to investigate complaints in a fair and independent way. The CQC uses information about concerns to inform and plan inspection activities, but cannot investigate individual complaints.

The agreement also gives CQC inspectors the capability to signpost the LGO ‘best practice’ resources and guidance directly to providers during inspections. This includes information for providers on how each organisation uses complaints and information of concern.

Monitor Urges NHS Trusts to Try Harder

Reproduced under license from Flickr: Paul Townsend

Monitor, England’s health regulator, has published its latest report on the operational and financial performance of the NHS.  The report recognises the efficiency savings already made but asks the NHS to do more to ensure patients receive quality care in the future.

Analysis of NHS providers’ operational and financial performance shows the sector as a whole made £741million in efficiency savings between April and December 2015. The analysis also shows that NHS providers treated 5.12 million emergency patients between October and December 2015.  However many providers missed several national waiting times standards, such as the A&E performance measure, in the last 3 months of 2015. In addition, the sector as a whole reported a deficit of £2.26 billion in the 9 months to the end of December 2015.

New measures developed with providers by Monitor and the NHS Trust Development Authority (TDA) to help organisations get a better grip on their finances are starting to have a positive impact. Many providers are beginning to use them effectively to arrest a previous rise in the use of costly agency staff, and have reduced, by £31 million, the sector’s overall spending on management consultants.

Jim Mackey, Chief Executive Designate of NHS Improvement, said: “This performance will be very disappointing for providers, and shows the range of difficulties they’re facing. Despite this, providers are making progress on improving their finances whilst also providing more treatment, to more patients with more complex care needs than ever before. However, further improvements will be required by the whole NHS at pace and scale to tackle the current financial and operational challenges it faces.”

“At NHS improvement, we intend to work with the providers to identify improvement opportunities, both recognising strong performers and supporting those who are struggling.”

Key findings by Monitor include:

·         The NHS provider sector recorded a deficit of £2.26 billion which is £622 million worse than planned.

·         179 (75%) out of 240 NHS providers reported a deficit.  131 were acute trusts.

·         £2.72 billion was spent on agency and contract staff which is £1bn more than planned.

·         Providers have estimated that delayed transfers of care have cost the sector £104m so far this year albeit other estimates put the true cost at a much higher level.

·         Providers made £1,94 billion of savings which is £257 million less than planned.

·         Providers have identified £452m of further financial improvement opportunities for the rest of the 2015/16 financial year.

·         The NHS provider sector as a whole missed the A&E waiting time target of seeing 95% patients within 4 hours between October and December 2015.

·         Between October and December 2015, 98,000 people waited longer than 4 hours in A&E for admission due to poor bed availability elsewhere in their Trust.

·         The size of the waiting list for routine operations reached 3.14m as providers failed the referral to treatment healthcare standard for the first time.

National Literacy Trust Competition Winners Announced

Each school term the National Literacy Trust runs a different competition to inspire children to get involved in activities to improve literacy and get excited about reading.

They have just announced the winners of their 2015 autumn term competition, The Editor Challenge, which gave Key Stage 2 pupils the chance to produce their own magazines.In partnership with Girl Talk and Mega magazines, budding young journalists were challenged to complete a series of activities:

• a celebrity feature,
• a review,
• a quiz,
• a storyboard
• and a front cover.

All the pupils who completed three or more activities were entered into a grand prize draw, from which Shokathia from John Scurr Primary School in London was chosen as the winner. She has won an eReader, £50 in book vouchers and a one-year subscription to Girl Talk magazine.  Her school has also won her school a visit from a storyteller and one-year subscriptions to five great Immediate Media Co. magazines.  

Shokathia said about winning: “It felt amazing, I was jumping for joy! It felt like all my birthdays had come at once. I had the biggest smile you can ever imagine and I kept trying to re-live that exact moment I was announced winner in my head. I was amazed at how many prizes I would be getting and shocked that I won out of the whole country.”

Each school that took part could also enter up to three of their pupils’ completed magazines into a bonus writing category. These were judged by a panel including staff from Girl Talk and Mega magazines. Lara from Talbot Heath Junior School in Bournemouth, was chosen as the winner and has won a tour of Immediate Media Co.’s head office.   10 runners-up also won a one-year subscription to either Girl Talk or Mega magazine.

The Literary Trust is running two new competitions for schools this term: The Spring Reading Adventure and Timmy Failure: Crack the Case.  To find out more visit http://www.literacytrust.org.uk/schools_teaching/competitions 

86 CQC GP Practice Reports Published - 79% Rated as Good or Outstanding

The CQC has published a further 86 reports on the quality of care provided by GP practices.  65 practices were rated as Good, three as Outstanding, eleven as Requiring Improvement and seven as Inadequate. In addition, two GP Out-of-Hours services have been rated as Good.

In total over 3000 inspections of GP services have now taken place, the majority of practices have achieved Good or Requiring Improvement ratings, whilst 3% at each end of the scale, have achieved Outstanding or Inadequate ratings.


Professor Steve Field, Chief Inspector of General Practice, said:“What’s enormously encouraging is that our inspections are driving improvement – 90% of practices that we have re-inspected have improved since last October. Through their hard work and dedication, practices are making positive changes to the care they deliver.


“There is still too much poor care. Since we began inspecting GP practices in October 2014 we have found over 100 practices to be Inadequate. While this is a minority, this still amounts to over half a million patients in England who were not receiving the basic standards of care that they should be able to expect from their GP practice. I am glad to say that we have increasingly found that most practices that are placed in special measures use the support that is on offer to meet those standards.”

Government Aims to Make NHS Paperless with £4bn Investment

Image reproduced under licence from Flickr: Newtown grafitti

All political parties agree that moving from paper to electronic records, appointment, monitoring and prescription systems will be more convenient for patients and help provide faster diagnoses.  

Over the last few decades parties of all persuasions have tried to get the NHS to embrace technology and ‘go paperless’ but there has been limited success. 

Successive governments have been criticised for wasting money on projects which did not meet their scope, ran significantly over budget, or over time.  The Labour government’s electronic medical records programme in 2002 was described as “the world’s biggest civil information programme’ but was scrapped after costs exceeded £10bn. 

Now the current government plans to try again, with proposals announced which will see a further £4bn of investment into paperless projects.

The Department of Health and NHS England are still to finalise spending plans, but they are expected to include:

• £1.8bn to create a paper-free NHS and remove outdated technology like fax machines.
• £1bn on cyber security and data consent.
• £750m to transform out-of-hospital care, medicines, social and emergency care.
• About £400m to build nhs.uk, develop apps and provide free wi-fi.  Allowing patients to book services and order prescriptions online, as well as speak to their doctor via secure video links.

One of the most exciting areas of development is the use of ‘apps’ to help patients manage their care.  Apps are in development to help promote health as well as diagnose illness, examples in development include an app to help prevent self-harm in young people, and one that will help care home workers identify the early signs of dementia among residents.

By 2020 it is hoped that a quarter of a million patients with long-term health conditions will be able to monitor elements of their health care at home using new apps, uploading real-time data, sending it straight to health care professionals, managing diabetes, hypertension and other long-term conditions.

2020 seem like a long way away?  By March 2017 the government wants to see at least 10% of patients using PCs, tablets and their phones to access GP services.

Talking the BBC, Health Secretary Jeremy Hunt said doctors found filling out paperwork and bureaucracy "so frustrating".

"We know that proper investment in IT - it's not without its pitfalls - can save time for doctors and nurses and means they can spend more time with patients".

Labour's shadow health minister Justin Madders said: "Rather than rehashing old announcements, Jeremy Hunt needs to be telling the public how he intends to sort out the crisis facing our NHS.

"The Tories cannot hide from the fact that the NHS is going backwards on their watch.
"Hospital departments have become dangerously full, patients are waiting hours in A&E, and the health service is facing the worst financial crisis in a generation."

Long Form Writing is Back!

Short form writing has been king for over a decade, spurred on by our use of technology, the arrival of apps including Twitter and Snapchat, and the need for journalists and advertisers to get their point across very quickly, often in a small space online.  But things are changing, media sites and advertisers are starting to see the value in the long form and it seems the general public like it.

In the last 18 months Facebook has launched Instant Articles, the Guardian ‘The Long Read’, and Snapchat ‘Snapchat Discover’, offering depth and brevity to subjects only superficially reported on through other media sites.  Even Twitter is getting on the band wagon, once sold as “a short burst of inconsequential information” it is rumoured to be changing its character limit from 140 to 10,000.

Talking to What’s New in Publishing, Rob Orchard, publisher of the quarterly magazine Delayed Gratification said: “There was a time when it was all about being shorter and cheaper”.

“When editorial budgets were slashed back to the bone that sparked a trend for short, snappy and cheap content. The idea was to get as many people as possible – often in the millions – to look at free content and monetise it through innovative ad formats.

“But the pendulum has swung back,” he says, pointing to ad blocking as a catalyst for publishers now “rewiring the economics of how their journalism is funded”. In looking for “new ways to win the battle” against ad blockers, Orchard believes more publishers have realised the potential for premium long form journalism, rich with content that readers are happy to pay for.

“We ask our readers to pay and help fund great journalism – it’s a model that’s worked for news outlets for many years,” he says, adding in the last two years there’s been a “swing in the mood,” with more readers willing to pay for content offering a different perspective.

Media analysts have also seen an increase in the use of long form writing by both journalists and advertisers, with advertisers seeing long form writing as a way to help communicate about and build a brand.

Paul Belford, founder of the ad agency that also bears his name said: “People will read what interests them and there’s no reason on earth why that can’t be an ad,” he tells attributes the rise in long form writing to “The promise of what the reader will discover and how interesting the writing is. And that’s down to the skill of the writer.”

Is the DWP Letting SMEs Down Over Auto-Enrolment for Pensions?

The Public Accounts Committee has been reviewing the Department of Work and Pensions plans for the roll out of pension auto-enrolment.  Whilst they commended the DWP on its work with larger employers, it has raised concerns over the support being offered to 1.8 million smaller employers, who will be enrolling staff between 2016 and 2018.

Automatic enrolment aims to reverse the long-term decline in the number of people saving into a workplace pension. Employers will have to enrol workers into a workplace pension scheme if they are working in the UK, earn more than £10,000 per year, are over 22 years old and are under State Pension Age. 

As of August 2015 5.4 million people had already been enrolled in a pension and although these pensions should increase people’s financial health in retirement, the committee has highlighted concern over the value of these pensions if people only pay in the minimum contribution rates.

They also raised concern over the complexity of the system SMEs are being asked to implement.  Recognising that SMEs have fewer resources to administer automatic enrolment than big businesses and that simplifying the process will be critical to the success of the programme. 

Their report calls on the Department to write to the Committee in 12 months, updating it on progress both in implementing auto-enrolment and against the Committee’s recommendations.

Meg Hillier MP, Chair of the PAC, said "Auto-enrolment is entering a critical stage which will affect 1.8 million additional employers and their staff. It is vital people can understand, implement and have faith in the system.

The Department for Work & Pensions must watch and learn from the experience of small employers and ensure easy-to-use tools are in place to support them. At the same time, swift action is required to ensure the Pensions Regulator can access accurate information.

There must be greater clarity on outcomes for employees—for example, those with multiple small pension pots—and also over the substantial loan, funded by the taxpayer, which was used to set up NEST.

Auto-enrolment is a huge undertaking with implications for millions of taxpayers but our Committee does not believe its success or failure can be properly evaluated in isolation.

The Department will in time conduct its own review of the programme and we would stress it is crucial this fully considers the impact of wider reforms that could affect people’s income in retirement.

We will be following the Department’s progress closely over the next 12 months and will expect it to respond effectively to the recommendations detailed in our Report as the roll-out proceeds."

BMA Calls for the Abolition of CQC Inspections

GPC Chair, Chaand Nagpaul

At a special conference of Local Medical Committees, held last week, GPs agreed to campaign against the CQC practice inspection regime, stating that the system requires significant and urgent reform.  They have asked the BMA’s GPs Committee to explore all options in which practices can ‘lawfully withdraw from engaging’ with the CQC.

Attendees of the conference backed an alternative quality assurance scheme, which would be peer-led and based on criteria that would improve patient care and safety. In a speech to the conference, GPC chair Chaand Nagpaul said the CQC itself needed to be put into ‘special measures’.  While, in an address to the meeting, Royal College of GPs chair Maureen Baker also called for the suspension of CQC inspections saying they were not fit for purpose. GPs at the special conference also demanded all fees paid to the regulation by GPs be fully reimbursed, and opposed proposed sevenfold hikes in CQC fees.

In response the CQC said: ‘We make no apology for acting in the best interests of patients, who tell us they want to know care services are safe, effective and responsive.

‘Not only do patients value our inspections, but GPs themselves have told us inspection has helped drive improvement (nearly two-thirds of those surveyed). We’ve also found over three-quarters (76%) of GP practices and out-of-hours services agreed their inspection provided a thorough review of whether they were safe, effective, caring, responsive and well-led. ‘We’ve worked hard to ensure that the inspection of GP surgeries does not impact adversely on the practice being able to provide patient care by working with practice staff to design the agenda for that day. The feedback we’ve received indicates that surgeries already performing well do not find the preparation for inspection arduous, as the BMA suggests.

Catherine Murphy from the Patients Association said: "We know from calls to our helpline that patients feel it is important that inspections of GP practices bring to light what’s wrong so that we are all aware of it and so that practices can improve. It is important that the work CQC has been doing in this area continues so that patients are safe."