Health Secretary Andrew Lansley has announced the plan to close down NHS Direct in England.

As the BBC reported: NHS Direct currently employs more than 3,000 staff, 40% of whom are trained nurses. It is understood the ratio on the 1-1-1 helpline is slightly less in the pilot, but no figures are yet available for what will happen when the scheme is rolled out nationally.

Critics claim the change would undermine the quality of the service by reducing the number of qualified nurses answering calls, but chief executive of NHS Direct Nick Chapman told the BBC the new helpline would be better and more cost effective than NHS Direct.

What do you think of the closure of NHS Direct and do you think that the new 1-1-1 service will act as a good, cost effective replacement?

Source. http://nhsmatters.co.uk/nhs-direct-closes-what-do-you-think/

Recruiters, employers and healthcare workers have welcomed plans for the introduction of a ‘skills passport’.

A one-year pilot project was conducted among nursing staff at seven English NHS Trusts during 2009/10 seeking to test ‘proof of concept’ for the passport which allows workers to create a verified online record of their skills, qualifications and experience. This can be viewed by prospective or existing employers as required.

According to research from sector skills council Skills for Health, employers liked the way the passport can cut unnecessary duplication of statutory and mandatory training and pre-employment checks each time a worker moves between employers, while nurses praised the passport’s potential contribution to career development and job mobility. 

Kate Bleasdale, executive vice chairman of HCL, told Recruiter: “With their uniquely transferable skills, the UK’s healthcare workforce is becoming more and more mobile and is also becoming increasingly inclined towards flexible working patterns. Any measure which supports these trends, and supports healthcare workers’ continued professional development, is welcome. With an increasing demand for healthcare professionals from a growing and aging population, it’s also vital for patient care that healthcare professionals can move seamlessly to new roles, with as little red tape as possible.

Caron Ratcliffe, director of nursing, Apex Health + Social Care, adds: “As a supplier of temporary staff to the NHS we would welcome the introduction of a ‘skills passport.”

The Department of Health (DH) has relaxed its position on the use of Criminal Record Bureau (CRB) Certificates, effectively introducing a limited system of “portability” for care services regulated by CQC.

This new approach applies in services provided to adults (but not children) in England and allows employers – under certain circumstances – to accept a Disclosure Certificate produced by a prospective employee, provided that the Certificate is no more than 3 months old and is at the appropriate level. In these circumstances, the employer does not need to complete a new application for a Disclosure. UKHCA has produced guidance for members on using portability in homecare services, which includes recent (DH) Dept of Health and CQC guidance.

The commission set up this week to reform care funding must give as much weight to the needs of adults with lifelong conditions as they do to older people, one of its three members has said.

In her first interview since her appointment, Jo Williams said people with lifelong conditions had particular funding needs due to a lack of assets, work or social opportunities, and the fact that few had their own accommodation.

She added: “That’s a group of people who clearly the commission will need to take account of as well as older people.”

Williams said she was drawing on her experience as chief executive of Mencap from 2003-8. Following her departure, the charity, among others, criticised Labour’s Green Paper on reforming care funding last year for neglecting the needs of younger disabled adults and concentrating on people who had developed care needs later in life after building up assets.

Williams also brings to the role a background as a social worker and a 30-year career in social services, including spells as director in Cheshire and Wigan and as president of the Association of Director of Social Services.

She was also confirmed this week as the government’s choice for chair of the Care Quality Commission, a post she has held on an interim basis for seven months.

The Commission on the Funding of Care and Support, which is chaired by economist Andrew Dilnot and also includes former social services director and Labour health minister Norman Warner, will hold its first meeting at the end of next month, Williams revealed.

However, it faces a tight timescale having been set targets to provide ministers with the criteria it will use to judge competing funding options by mid-September and also to feed into the government’s spending review, which is due to report on 20 October. Its final report is due by next July and Williams said she would be contributing one day a week to its work.

Williams said: “I don’t think [the timescale's] negotiable. There’s an expectation that we will deliver to that date. We need to roll our sleeves up.”

She said the commission would have to decide how much capacity it had to “get the balance right between engagement, listening to people, taking evidence, reading documents and looking at what’s happening in other countries”.

Williams said the commission would draw upon previous evidence on the issue, which includes work done by the Labour government over the past year, but said she could not tell whether it would have to commission new evidence.

Jo Williams is a Board member of the Care Quality Commission and was the former Chief Executive, Royal Mencap Society. She is also the former president of the Association of Directors of Social Services and champion for social care services throughout a career in local government. She is also Co-chair of the Learning Disability Coalition and a member of bodies advising government on the third sector, carers, learning disabilities and children’s services

Firms which already have small-scale involvement with family doctors are preparing to exploit the chance to gain an unprecedented foothold in the NHS once GPs start spending £80bn of NHS funds.

They said they expected the switch to GP commissioning outlined in the white paper to help them have a much wider involvement with the NHS, and especially to work closely with the 300-500 new “consortiums” of GPs which the Department of Health expects to emerge to become key purchasers of treatment for patients.

Bart Johnson, chief executive of Assura Medical, said: “We are enthusiastic about the reforms. Assura Medical already works with groups of GPs across the country providing a whole range of services. We see this as a good opportunity to build upon our current work with GPs and the NHS to improve health outcomes for patients.”

Kingsley Manning, business development director at Tribal, which also already provides commissioning support services to some parts of the NHS, cautiously welcomed moves which the firm said “could lead to the denationalisation of healthcare services in England”.

Manning, a visiting professor at the business school at Imperial College London, added: “There is a significant opportunity to improve commissioning in the NHS. We can help because we make the investment in the technology and skills needed to save the NHS money. We have done so with many primary care trusts [PCTs], saving millions.”

Bupa Health Dialog, a subsidiary of the global health giant’s UK arm which specialises in extending the firm’s relationship with the NHS, also expects to gain work. “We would say that the new policy represents a significant opportunity for us to work with more and more GPs, and GP organisations, to improve outcomes and quality [of care] for patients”, said the subsidiary’s managing director, Bob Darin. A “significant” number of GPs “will want to work with Bupa or companies like us to provide tools to help them take a holistic view of their local population’s clinical needs and thus make more informed commissioning decisions”.

Doctors’ leaders and health experts agree that GPs’ clinical skills will not be enough for them to discharge their new responsibilities and that the consortiums will need help them with finance, management, accountancy and data analysis.

Nick Goodwin, a senior fellow at the King’s Fund health think-tank, said: “It’s likely that many of the GP consortia will need to either hook up with a PCT or go outside the NHS to firms like Tribal, United Healthcare or Bupa Health Dialog. Most PCTs don’t have the expertise to offer technical skills, like information systems that allow them to understand the health needs of their local population.”

But the British Medical Association, the doctors’ trade union, voiced alarm at the likely expansion of private firms’ role and said that most GPs would aim to perform their expanded role without them. “The BMA position on this is that we would not be happy [for private sector involvement]. We don’t think it is necessary”, said Dr Laurence Buckman, chairman of the BMA’s influential GPs committee.

“I think the vast majority of GPs will not be keen to involve the private sector in this. This is an opportunity for GPs to unite to make sure that the health service works well for the people of England, without the involvement of the private sector,” he added. The issue could lead to tension between the BMA and the Department of Health in forthcoming negotiations about implementation of the planned changes.

A BMA spokesman added: “We are concerned that increased private competition within the NHS could lead to wasteful expenditure or the duplication of services, for example independent sector treatment centres providing the same services as as the NHS, when that money could be spent on frontline patient services.

“We have always said that the private sector is no more efficient than the NHS and a lot of money is being wasted on private sector contracts and companies. We feel the involvement to date of private sector companies hasn’t delivered many benefits to patients or the NHS. It’s much better if you have services wholly provided by the NHS. The private sector should be the provider of last resort.”.

He cited the possibility of management consultants coming in to do jobs currently done by NHS staff. “We would be very concerned about that,” he said.

The health secretary’s message that independent operators are welcome to carry out work for the NHS rips up attempts by Labour’s health secretary, Andy Burnham, to establish the health service as “the preferred provider” of NHS services.

David Fleming, national officer for health with the Unite trade union, denounced GP commissioning as “an untested, expensive Trojan Horse in political dogma that will give private companies an even greater stake in the NHS – this way of operating has already happened in the USA.”

The NHS Support Federation, an independent campaign group, said GP commissioning “will create a spaghetti-like snarl of conflicting interests, where profit will inevitably come before patients. Paying companies to spend the huge NHS budget on other companies is a recipe for scandalous waste and the sort of shady deals that the public must be protected from,” said the group’s director, Paul Evans.

SOURCE

Depression can significantly increase the chances of developing Alzheimer’s disease or other forms of dementia later in life, the research suggests.

The findings, from a US study, reinforce a perceived connection between depression and Alzheimer’s, and other forms of dementia.

Scientists have yet to discover what causes the link but have pointed to brain inflammation, the action of certain proteins, and lifestyle factors as possible drivers.

The latest research involved almost 1,000 people with an average age of 79 who had been enrolled into a large US heart study.

At the beginning, all were free of dementia. Psychological tests identified that 125, or 13%, of the study participants, were classified as being depressed.

By the end of the 17-year study, 164 of the recruits had dementia, of whom 136 were diagnosed with Alzheimer’s.

Nearly 22% of those who were depressed at the outset developed dementia compared with 16.6% of those free from depression. They were around 30% more likely to acquire a dementia illness.

Leading researcher Dr Jane Saczynski, from the University of Massachusetts Medical School in Worcester, US, said: “Inflammation of brain tissue that occurs when a person is depressed might contribute to dementia. Certain proteins found in the brain that increase with depression may also increase the risk of developing dementia.”

The results, published in the journal Neurology, were unaffected by a person’s age, sex, education, or possession of the defective APOE gene that is known to increase the risk of Alzheimer’s disease.

Leading domiciliary care providers’ representative, the United Kingdom Homecare Association, reacts to the emergency budget of the new Government as follows.

While recognising that a 2.5% increase in VAT will affect many businesses, this additional cost is a double-blow for the UK’s homecare providers. Regulated care services are currently exempt from VAT, meaning that although customers are not charged VAT, homecare providers themselves are unable to reclaim tax on the goods and services necessary to deliver the service. At the same time, providers have little chance – if any – of recovering these costs from their cash-strapped local authority purchasers.

UKHCA’s Chair, Mike Padgham, said: “UKHCA’s Board is due to meet and consider a range of options, including a concerted campaign to get regulated care services zero-rated status.”

In addition, spending cuts that the budget demands from councils – who are the majority purchaser of social care – are routinely passed on to independent sector providers. At the same time councils are creating more onerous and costly contract arrangements. Padgham continued:

“Care providers realise that they will share in the pain to put the country’s finances on an even footing, but the homecare sector has already been subject to a relentless pressure to lower prices long before the current financial crisis. Increased taxation and public spending cuts mustn’t be allowed to damage essential frontline services.”

Ends.