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NAPC Bulletin 8 May 2012

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Created on Tuesday, 08 May 2012 08:30

Last Updated on Tuesday, 08 May 2012 08:30

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NAPC Bulletin 8 May 2012

Company’s Hospital Deal Means Cuts

The first private company to run an NHS hospital will get £2 million from any surplus, which could lead to cuts, according to details of its contract.

Hinchingbrooke Hospital, which was taken over by Circle, has agreed a ten year contract.  Ali Parsa, chief executive of Circle, said Hinchingbrooke was forecast to keep losing ‘many tens of millions’ if it was kept under direct NHS managements.

Patent Expiry Good For NHS

Pfizer’s cholesterol curbing medication, Lipitor, lost its patent protection in Britain at the weekend, allowing drug companies to flood the market with cut price copies.

The NHS spends £306 million on it annually, ranking it second only to the national outlay on hay fever inhalers, but the price is set to slump by as much as 85 per cent.

Lipitor, one of a class of medicines known as statins, is the most lucrative product in the history of the pharmaceutical industry.  It has generated more than $125 billion of revenue globally for Pfizer, since Bruce Roth, an American scientist, invented it in 1985.

The drugs industry wants longer patents, arguing that its costs an average of £1.15 billion to develop a new medicine from scratch.

A spokesman for the Association of British Pharmaceutical Industry said: ‘Only one in every 5,000 compounds studied in the research phase ever actually becomes a treatment for disease.’

Shambolic Procurement Puts Off Bidders

Concerns about the ‘rushed’ and ‘shambolic’ procurement process for the NHS 111 non-emergency phone service are deterring private sector providers.

It is understood that Serco, which provides an out-of-hours urgent care service in Cornwall, has decided not to bid for any of the NHS 111 contracts which are being awarded on a primary care trust cluster or regional basis.

Capita and Care UK have formed a partnership to bid for NHS 111 but are still undecided about there to join the race for contracts, most of which will be awarded this summer.

NHS 111 must be rolled out nationally by April 2013, when it will replace NHS Direct’s 0845 number.  It has attracted interest from ambulance trusts, GP out-of-hours providers and some major outsourcing companies, as well as NHS Direct.

However, senior sources involved in the process have complained of inflexible block contract arrangements which do not share risk in the event of greater than expected demand.

A source from one prospective bidder said the process was unnecessarily ‘rushed’ and warned it was impossible to predict demand before the pilots had been fully evaluated.  Initial results showed variation in call volumes between different pilot areas.  ‘Despite this, the tenders are all for block contracts’, he added.

A senior source from a competing organisation commented: ‘If the government wanted to take NHS Direct and had it to the ambulance service, why didn’t they just do that, instead of going through this shambolic procurement process?’

Two contracts have been awarded so far.  The North East’s went to a partnership between North East Ambulance Service Foundation Trust and Northern Doctors Urgent Care Ltd, while East of England Ambulance Trust was successful in Norfolk.

The British Medical Association council member and GP, Dr Peter Holden, who is in NHS 11 pilot in Derbyshire, raised concerns about the ability of ambulance services to cross-subsidised. ‘There seems to be very definite lack of a level playing field’, he said.

Formula Aims To Settle CCG Disputes

Guidance from the NHS Commissioning Board has set out new principles for ‘firming up’ clinical commissioning group boundaries, and an elaborate formula for resolving disputed areas.

However, even if applied everywhere, the formula still leaves around 8 per cent of the population, or four million people, living in areas not assigned to a CCG, with large gaps in the north of England and West Midlands.

Although CCGs are made up of GP practices, they will also be responsible for a defined geographical area.  The precise boundaries have proved difficult to agree as practice catchment areas often overlap.

The guidance to has been sent to primary care trusts.  It sets out a new principle of ‘containment’.  This states that more than 75 per cent of the population in a CCG’s geographical areas must be registered with that CCG’s member practices – and that 75 per cent of the member practices’ patient lists must live within the CCG’s designated area.   It also reveals that CCG areas should be built up from ‘lower super output areas’, defined areas with a population of 1,500 used by the Office for National Statistics to collect data on local communities.

The Board said CCGs should, where possible, avoid configuration which places member practices in another CCG’s geographical patch.

The document sets out a complex eight stage formula for deciding which lower super output areas are assigned to each CCG.

If the formula were applied to each of England’s 32,482 lower super output areas, there would still be 2,763 areas, with a total population of 4.1 million, which are not assigned to a CCG.   The guidance leaves small, unresolved areas on most boundaries between CCGs, and large gaps in Staffordshire, the Black Country, Surrey and Yorkshire.

The document offers to make available the results of the exercise, where CCGs are struggling with their boundaries.  However, it stated: ‘It would be possible to develop further stages to assign most of the remaining areas......but this would likely require a more manual process and therefore take longer and involve an element of judgement’.

One PCT commissioning officers commented: ‘Practices have been around a lot longer than lower super output areas.  If you force this too hard, you’re going to start a wave of disengagement, although you nearly had everything sorted.  It will cause turbulence where it didn’t exist before.

A Commissioning Board spokeswoman said the document was ‘a guide, which is not considered to be prescriptive or policy’.  She went on to say that where CCG area had been agreed, but were not in accordance with the guidance, CCGs did not necessarily need to start again.’

Dr Charles Alessi, Chairman of the National Association of Primary Care, said the principles were ‘a useful starting point as long as they are not interpreted inflexibly.  I can see if people fo in with hobnailed boots and say ‘this is right’ and ‘this is wrong’ without understanding the natural communities that exist, it isn’t go to work’.

Newborn Twins Died After Morphine Overdose

Newborn twins died after doctors at Stafford Hospital accidently injected them with 17 times the prescribed amount of morphine, an inquest heard.

Alfie and Harry McQuillan were given the drug after they were delivered three months early.  They died two days later suffering from lung injuries, bleeding around the brain and other health problems.

South Staffordshire coroner’s court heard that the boy had previously been in good condition at the scandal-hit Stafford Hospital on 30 October 2010.

GSK Brings Women To Fore In Latest Reshuffle

Jing Ulrich, chairman of JP Morgan’s Chinese investment banking operation, and American oil executive, Lynn Elsenhans, are to join the board of GlaxoSmithKline in appointments that will give the group more women in the boardroom than any other blue-chip company.

The pair will join GSK in July, bringing the number of women on the board to five out of 16 directors.  No other FTSE 100 company has as many women directors.

GSK’s new directors were named during the company’s annual meeting, at which it rejected buying its struggling rival, AstraZeneca.  Responding to shareholders’ questions, GSK’s chief executive, Andrew Witty, said that it would be very distracting to merge with a huge peer.

US Seeks Uses For Abandoned Drugs

The US government has announced that it will work with large pharmaceutical companies to try to find new uses for once-promising drugs that have been cast aside by the industry.

The National Institutes of Health initially will work with Eli Lilly, Pfizer and AstraZeneca in what it terms ‘matchmaking’ between the companies and researchers from universities, hospitals and the NIH. 

The three companies and NIH declined to identify the 20 or so drugs that initially will be part of the collaborative programme, but said they either had failed to either help treat specific diseases or, in some cases, the company involved may have abandoned its research.

Trend In Medical Research Is Troubling Scientists

The US Food and Drug Administration says it is reviewing the conflicting UK data on the class of osteoporosis treatments known as oral bisphosphonates after two research teams separately analysed data from the same UK patient database to see whether widely prescribed osteoporosis drugs increased the risk of oesophageal cancer.

One study found no increase in patients’ cancer risk, but the second study, which ran three weeks later, found the risk for developing cancer to be low, but doubled.

Four In Ten Patients Do Not Opt For Nearest Hospital

A study has found that almost half of NHS patients who  underwent hip replacement operations did not opt for their nearest hospital,

Out of almost 40,000 patients tracked in the study,  which used official data, four in ten patients decided on a hospital that was not their nearest. 

Researchers found ‘that quality matters to patients; the lower mortality rate and the shorter waiting time, the more likely patient is to choose a hospital’.  Having a lower MRSA rate was also an important consideration, they said, as was being highly rated by the Care Quality Commission.