Today in healthcare: from Reform's Rising to the Nicholson Challenge Summit13 June 2012
1.36pm: Jessica Fuhl writes
This morning's summit is drawing to a close with a couple of questions and comments from the audience. Measuring community care and longterm conditions is a topic which has cropped up a few times. Another audience member asks Stephen Dorrell if he can paraphrase the chair of the health select committee by saying, "efficiency savings may have been possible two years ago but we haven't acted fast enough and we've now missed our chance". No answer is given, but there are murmurs of agreement from the audience.
That's it from this morning's summit. If you want to catch up on anything that you may have missed, take a look at the #reformrising hashtag on Twitter. You can also let us know your thoughts on some of the issues that have arisen by commenting below.
1.10pm: Jessica Fuhl writes
Chair of the health select committee Stephen Dorrell is delivering today's final presentation. He says the committee set out the aims of the Nicholson challenge at the start of the new government, as everyone knew it was "the biggest challenge facing the healthcare sector". He adds a familiar line: "My view of health service management change is that I'm not in favour of top-down organisational restructure."
Dorrell lists three ways that he thinks the new health act is progressive:
- Engagement of clinical community - not just GPs - in commissioning
- Closer links to local politics through health and wellbeing boards
- The transfer of public health from the narrow understanding of the NHS, and seeing local government being held up as accountable to the public health agenda
Dorrell explains that he doesn't like referring to the number of £15-20 billion in efficiency savings:
"It never seems clear what that number is. It is not cuts, it is a whole-service reconfiguration. The only way you can meet the Nicholson challenge is to regcongise that it is a system-wide challenge,and should include areas like housing and social care. That is how we need to respond to enable us to meet the Nicholson Challenge."
1.02pm: Jessica Fuhl writes
"Care needs to produce the actual results", says Stephen Thornton from the Health Foundation as he begins his presentation on "a new culture of patient-centred care".
Thornton is an engaging speaker and has a strong view on the new NHS information strategy. He calls it a a consumerist charter, as it depends on the view that giving people information gives them power. "But information alone is not power" he says.
The chief executive of the Health Foundation gives the example of him knowing how an egg is fertilised does not make him pregnant - similarly, "giving people knowledge does not make a difference". He calls the strategy "ideological" makes a very passionate case.
12.40pm: Jessica Fuhl writes
The next session on using technology in wellness and disease management has now begun. The vice-president of McKesson Healthcare Solutions, Kevin Ryan, and chief executive of the Health Foundation, Stephen Thornton, are each giving short presentations in this area.
Kevin Ryan tells the summit:
McKesson used a multi-disciplinary care team and advanced technology solutions to enhance the value of a disease management programme designed to help more than 260,000 people. Over the course of the first four years of the programme, the programme resulted in $569 million in net savings for the state.
12.26pm: Jessica Fuhl writes
We're whizzing through the sessions now - there's a lot to get through in one morning.
We've now just started hearing from the chief executive of the King's Fund, Professor Chris Ham, and the previous chairman of the Kaiser Foundation, Dr David Lawrence, on integration. We covered the King's Fund conference on creating incentives for integration earlier this year.
Lawrence says one must consider how technology is used in a whole system: "You cannot design and manage healthcare in anything other than a stream. You need to have insight at every stage."
Ham explains that it seems "integrated care does not come naturally". He argues that governments in the UK have made policies that do not encourage, support or highlight joined-up approaches to care. He adds: "Integrated care takes many different forms, there is not just the Kaiser example. We need to realise there is not a single best way to receive integrated care, but there are some common characteristics."
These characteristics are listed as:
Knowing who it is you are serving
Aligning financial incentives for integrated care
Well developed systems of clinical leadership
Good information technology
12.11pm: Jessica Fuhl writes
Paul Corrigan is now talking about the obvious benefits of "paperless hospitals" and innovation.
He elaborates on some of the points he put forward in his blog this morning:
In the NHS there is a higher proportion of staff trained in science per square inch than almost any other industry. It is therefore not surprising that the spark of innovation takes place within the NHS at very regular intervals, all over the service.
Every week or so the media splashes another stunning breakthrough which could relieve pain and distress. This means that modern medicine is one of the main drivers for continuous change within our health service.
But in other industries innovation is put to a broader purpose to transform the economics of the whole service and therefore ensure the service can reach many more people.
You can read more on his blog here
11.37am: Jessica Fuhl writes
After a break we're now back and hearing from the chief executive of Aintree University Hopsital NHS Foundation Trust, Catherine Beardshaw. The hospital is one of the first in the country to become "paperless". She is explaining how helping clinicians understand how to use their new electronic patient records system has been the hardest part of the process.
For a one off cost of £1.5 million, the new system is saving the trust £1.4 million a year.
She got a few laughs from the audience when she explained that doctors at the trust told her in the future the only paper they want to see on their desks is "the bad news box of tissues".
10.57am: Jessica Fuhl writes
Here's a Storify of what's been happening so far this morning
We've also got a new piece on the network, by GP Ayan Panja, who says a new approach is needed to men's health:
We know that men die younger, smoke more, drink more alcohol and ignore symptoms more than women. And many people say to me "So what?". And I reply it is inexcusable in this day and age to die prematurely through ignorance or not feeling like you can access healthcare adequately.
10.25am: Jessica Fuhl writes
The comparison of how much the journalism industry has changed in the last thirty years, and how little the NHS has, is the biggest issue for Sarah Neville, public policy editor of the Financial Times.
Neville has written about competition previously, assessing in February the value of competition in the NHS.
She stresses that community care financial productivity cannot be measured.
10.17am: Jessica Fuhl writes
Dr Penny Dash says "we need to go further, faster and more radically to face the challenge of the problems we have today".
She uses the examples of 120 newborn babies who died unexpectedly out of "normal working hours", and the figure of 26,000 people with diabetes dying unneccessarily each year due to poor quality of care to demonstrate "obvious" challenges that "get brushed under the carpet".
Dash explains what she feels we need to be doing more of to save money:
We could use the user. There's some people in Cardiff who have created a system where if they want to see their GP they enter in their own health details. This saves 50% of time at least. And this can be applied everywhere; most of antenatal care can be done by the mother.
We also need far more information sharing - we don't share information with each other and the public - and to challenge the image of the profession. In New Zealand they have one midwife delivering 60 babies a year - we should be doing this too. Why are there restrictions for us?
10.01am: Jessica Fuhl writes
We're now starting a session where the issues that Paul Johnson raises "will be looked at more closely".
Joining the panel to discuss some of the problems that the NHS will be facing is Sue Slipmanm (chief executive of the Foundation Trust Network), Dr Peter Carter OBE (general secretary of the Royal College of Nursing), Dr Penny Dash (Partner at McKinsey & Company), and Sarah Neville - public policy editor at the Financial Times.
Sue Slipman is emphasising the need for support to take risks. "We've got six months to get rules right", she says.
For Peter Carter, the Royal College of Nursing is "absolutely clear that the NHS needs to make savings". He also explains that the last government missed an opportunity as they "pumped a lot of money in to healthcare, but into the same things in the same ways".
He also makes the interesting observation the the NHS is the "national sick service" - and that we need to reclaim an approach to make it the "national health service" once again. Obesity and binge drinking are key factors that need urgently addressing to make longterm savings, he also adds.
The hashtag for today's event is #reformrising if you would like to follow on Twitter.
9.42am: Jessica Fuhl writes
Morning all. Apologies for some technical difficulties we appear to be having. Director of the Institute of Fiscal Studies Paul Johnson is introducing the themes that will be discussed today by talking about the future of economic healthcare policy. He is explaining that the NHS is "taking up an increasing share of the cake" in terms of public spending.
You can catch the full programme of speakers and issues that will be discussed today online here.
8.39am: Clare Horton writes
Here's the health headlines from around the web this morning:
Patients' trust in doctors will fall if doctors are allowed to hold up compulsory checks being brought in to ensure they are still competent, reports the Telegraph. It says Katherine Murphy, chief executive of the Patients Association, has written to Andrew Lansley, the health secretary, to urge him to press on with the introduction of revalidation, a proposed system of five-yearly checks.
Lifestyle advice given to tackle male infertility may be futile and could delay other options, reports the BBC.
And on the network, Carolyn Gullery explains how increased community care has helped Canterbury deliver better health services after being severely weakened by an earthquake in 2011.
8.25am: Clare Horton writes
Good morning and welcome to the daily blog from the Guardian's healthcare network. Today we'll be reporting from thinktank Reform's Rising to the Nicholson Challenge: International technology summit. Speakers include Stephen Dorrell, chair of the Commons health select committee; Sue Slipman, director of the NHS Foundation Trust Network; and health commentator and former Labour adviser Paul Corrigan.
Before the event begins, here's a quick look at this morning's headlines.
Senior doctors are claiming that some drug trials, carried out after a medicine has won its licence, are more to do with increasing sales than science, reports Sarah Boseley for the Guardian.
The European Centre for Disease Prevention and Control is warning that gonorrhoea is on the way to becoming an untreatable disease as strains resistant to antibiotics spread further.
And former carer Judith Cameron writes about how GPs are realising that giving support early on can reduce the strain on those who care for family or friends.