NAPC News 16 April 2012

Mandate Must Set Out Clear Vision And Reflect Reality

The mandate, which received little attention during the Bill’s journey through Parliament, is essential part of the reformed health system.

The mandate is designed to be the main mechanism through which the government expresses its will, and the will of the people, on what the NHS should prioritise.  The NHS Commissioning Board (NHS CB) will translate the mandate’s priorities into guidance for clinical commissioning groups.

Although the government has the right to issue a new mandate every year, the intention is for it to cover the three-year public spending cycle, with annual refreshes produced if necessary.  The first mandate will be something of a halfway house, arriving one year into the current cycle.  Having published the mandate, it is intended the new NHS runs itself.

National Voices, the umbrella body for health and social care charities, argues the mandate should echo the BBC charter in highlighting clear ‘purposes’.  It rejects ‘alienating’ ideas of making indicators related to the NHS outcomes framework its ‘centrepiece’. 

A citizens’ jury, however, put together by consultants, PWC, seemed to indicate a degree of public comfort with the use of framework indicators.

According the Health Service Journal, creating and translating the first mandate will be a tricky balancing act between setting out a bold vision for improvements in care quality, while recognising the system to be put in place to realise tht vision is still, in large parts, being constructed, tested and, inevitably, reconfigured.

6,000 Women In NHS Implant Checks

Nearly 6,000 women, who received faulty implants have now been referred to the NHS.  They include more than 1,000 women who paid for breast operations carried out by the Harley Medical Group.

CCGs Must Sign Development Plan

All clinical commissioning groups (CCG) will sign a ‘development agreement’ with the NHS Commissioning Board (NHS CB), which could commit them to pursuing acute reconfiguration or tackling local financial problems.

The NHS CB’s draft guide for applicant CCGs, issued on Friday, confirms the details of the CCG authorisation requirements.  It also confirms the timetable under which CCGs will be told whether or not they have been authorised.  The bulk will learn their fate between October and January.

The guide also says that CCGs will be asked to sign a ‘development agreement’ when they are authorised.  It indicates that agreement could be used to set priorities for particular CCGs, such as addressing a ‘financial challenge or major reconfiguration plan for acute services.’

If CCGs are not fully authorised, they will be given either specific ‘conditions’ or ‘directions’
by the Board.  In what is expected a small minority of cases, they could have all their duties and budget passed to another nearby CCG, or to the Commissioning Board.

The guide for applicants says that CCGs that are given conditions and directions will ‘agree with the NHS CB a time-limited rectification plan’ for their removal.  Details of the conditions are likely to be decided on a case by case basis.

Likely options include CCGs being told to employ particular senior staff to help run it or support its development.
One of the authorisation requirements most concerning CCGs is a survey of more than 50 figures in their local health economy.  It is understood these will include specified individuals such as local authority directors.

Conflict Rows Will Go To Commissioning Board

Providers are likely to have to first complain to the NHS CB before approaching Monitor with concerns about clinical commissioning groups’ conflicts of interest.

Further details of the new commissioning system and economic regulation regime, including how complaints will be made and handled, are due to be set out in regulations in the summer.

The Department of Health last month asked the Cooperation and Competition Panel to review the issue of commissioners’ conflicts of interest.  Ministers made the request following a complaint about an urgent care consultation undertaken by NHS Peterborough.

Those with a complaint about commissioners’ decisions on primary or community services, where GPs might be conflicted, are likely to have to first contact the NHS CB.  If they remain dissatisfied they will then be able to complain to Monitor.

This mirrors current rules, which require complainants to try to resolve their problems with commissioners before approaching the competition regulator’s decision making panel.
Monitor is due to take on the competition regulator’s decision making panel and staff as it develops its economic regulation functions.

Private Medical Market To Be Investigate Over Bribes

The Competition Commission has begun an investigation into Britain’s private health market amid concerns that bribes paid to consultants are not only pushing up costs three times faster than inflation, but leading to unnecessary treatments.

Health And A Reshuffle

Conservative Health Secretary, Andrew Lansley, has urged the Prime Minister not to include him in any reshuffle, arguing that his work as Health Secretary will not be complete by the end of the year.

Conservatives are determined not to give the role to a Liberal Democrat, this giving their coalition partners a chance to appear to be riding to the rescue of the NHS.

Breast Cancer Drug That Prolongs Life Is Available On NHS

Women in London with hard to treat breast cancer have been given access on the NHS to a life-extending drug.
Avastin is one of the few drugs available for women with advanced stage breast cancer and other aggressive forms of the disease. Trials have shown it can give between five and 10 extra months of life.

NHS London has also approved Avastin for patients with colon and advanced ovarian cancers.

Cigarette Branding Ban To Hit Sweets And Alcohol

Sweets and alcohol could be banned from using fancy packaging.  The Secretary of State for Health, Andrew Lansley, last week announced a consultation on the branding of tobacco products, which might mean they could be sold only in plain boxes. 

The consultation, which starts today, examines whether tobacco companies should be forced to use plain packaging, as attempted in Australia.

Deborah Arnott, the head of Action on Smoking and Health, welcomed the plan.  ‘The consultation is just the first step, putting us in pole position to be the first European nation to put tobacco in plain, standardises packs.’
Critics have complained that such an approach would clear the way for sweets and alcohol to be stripped of their labels.

Safety Fears Over E-Cigs

Health experts are calling for tighter controls on electronic cigarettes, amid fears they expose users to dangerous chemical.

The nicotine vapour inhalers hit the headlines earlier this year when the insurance firm, Standard Life, banned workers from using them at their desks.

Fake Tan Can Make You Fat

Researchers in Sweden have claimed that phthalates – a man made substance used in fake tanning lotions - could lead to obesity, and that people exposed to the chemical are twice as likely to develop diabetes.

A billion tons of phthalates are produced worldwide each year, and they have been widely used as gelling agents in cosmetics, and in body products, like face creams, fake tan, make-up and perfumes.

The Expert Who Played God

As 10,000 children are taken into care each year, it is claimed that one doctor has profited from this by setting patients bizarre tasks, allegedly testing whether parents are fit to keep their children.

The doctor, who has not been named, is being investigated by the General Medical Council, following accusations that he deliberately misdiagnosed parents as having mental disorders to allow Social Services to remove their children into local authority care.

Third Mother Dies At Hospital Where Five Babies Lost Lives

A mother has died at a hospital where the maternity unit is under police investigation for alleged ‘poor care’ following the deaths of two women and five babies.  An internal NHA probe has begun and an inquest will open in the coming days.

Carly Scott, aged 26, died at Furness General Hospital in Barrow on Wednesday.  She had been discharged just days earlier after having her first baby.

Hospital officials refused to discuss the circumstances of the case.