Wednesday 24 December 2014

HSCIC; Code of practice on confidential information published

In September 2013 the HSCIC published a guide to confidentiality in health and social care, which provides patients and health and care staff with clear, accessible guidance on the handling of confidential information.


Network lock image


The code of practice on confidential information (PDF, 1.3MB) aims to complete the picture by providing good practice guidance to those responsible for setting and meeting organisational policy on the handling of confidential health and care information (e.g. board members).


The code clearly outlines the steps in the information-handling life-cycle that organisations must, should and may take to ensure that confidential information is handled appropriately.


The code applies to any organisation that collects, analyses, publishes or disseminates confidential information, ranging from GP practices and hospital trusts to commissioners and local authorities. The code will help organisations ensure that the right structures and procedures are in place to help front-line staff follow the confidentiality rules.


A consultation on a draft code of practice took place in summer 2014. We have published a response to the consultation feedback (PDF, 2.9MB) which outlines some of the key issues raised and how this feedback was taken forward in the final document.


The code of practice is a living document and we are committed to updating it regularly. We are particularly keen to draw on the experience of other organisations and include more practical examples of practice.


If you are aware of examples we could include in future iterations of the code, or would like to provide feedback on the document, please contact us on tel: 0845 371 3671 or by email to exeter.helpdesk@hscic.gov.uk.


Source HSCIC http://systems.hscic.gov.uk/infogov/codes/cop



HSCIC; Code of practice on confidential information published

Tuesday 23 December 2014

NW London district nurses go mobile



London North West Healthcare NHS Trust has introduced a mobile working solution from Vodafone for its district nurses, removing the need for them to record the same patient data twice.


The trust’s 245 district nurses previously kept paper records of their visits to patients’ homes. On return to the clinic or hospital, they would either enter the information into the trust’s RiO system themselves, or hand it to a data input clerk to enter it.


It was an inefficient and potentially error-prone process, said Yvonne Leese, director of community services at the trust.


“The end of the process is always checked by the clinician and signed off. Sometimes they would identify errors and say, ‘You’ve misread my handwriting’ – but all of that takes time.”


Leese said the trust was keen to modernise the service, and that commissioners supported the move towards mobile working.


It brought in Vodafone to implement a mobile working solution, using TotalMobile software on Samsung Galaxy tablets.


Gerard Traynor, IM&T programme director for the trust, said: “The key advantage of TotalMobile was that it enabled us to integrate with our RiO community system.


“The other key was the ability to work offline. It didn’t entirely depend on having a 3G or 4G connection, so you can still use the device even if you’re in an area that doesn’t have a signal. When it gets a signal it will reconnect.”


The devices are password-protected and data is encrypted. Remote management software is used to track the devices and wipe data if they get lost.


The district nurses have been using the mobile devices since October. Although some nurses were initially cautious feedback a few weeks into implementation has been very positive, said Leese.


Nurses can use the devices to look up relevant information, she added: “Before you might not have had access to the full patient record in the patient’s home, but this allows you access to up-to-date information that informs what you do and saves you time.”


Previously, work had been allocated manually via an allocation book. Now the mobile devices are used to allocate work electronically, in real time, said Leese.


“There’s less likelihood of somebody going to see the wrong patient or going to see a patient when a message has come in to say they won’t be at home that day because they’ve gone to a hospital appointment.”


The nurses are also using the tablets in other ways, such as sharing information with patients about their condition, or working out routes using the maps application.


The trust anticipated that the new system would slow the nurses down initially, said Leese, and this proved to be correct.


There was a dip in performance for the second half of October and the first part of November. “When we look back at the whole of December, we expect to see that start to come back on track,” she said.


Source EHI 22 December 2014   Kim Thomas http://www.ehi.co.uk/news/EHI/9804/nw-london-district-nurses-go-mobile



NW London district nurses go mobile

Monday 22 December 2014

NHS set to deliver 'world-leading' genomics centres

Genetics research plans could help create more bespoke medicines


100,000 Genomes Project UKNHS England is to create 11 new centres across the country that will lead the way in delivering on the UK’s ’100,000 Genomes Project’.


The project, first outlined by the Prime Minister David Cameron two years ago, aims to transform diagnosis and treatment for patients with cancer and rare diseases.


The new Genomic Medicine Centres (or GMCs) are the first in several waves of new centres that will be established across the country.


The first wave will cover areas including: Greater Manchester, the North West coast, Oxford, Birmingham and the West Midlands, Southampton, London, Cambridge and the East of England, Exeter and the South West Peninsula, and the North East.


Over the lifetime of the project NHS England’s ambition is to secure over 100 participating NHS trusts for additional GMCs to provide comprehensive coverage across the NHS in England.


NHS England says in a statement that they have ensured that the GMCs meet the requirements to deliver the project.


It is anticipated that around 75,000 people will be involved, which will include some patients with life-threatening and debilitating disease. Recruitment to the project will begin from 2 February next year.


After samples are collected, they will be sent securely to its gene sequencing partner Illumina – results will be returned to the NHS for validation and clinical action.


Professor Sir Bruce Keogh, NHS England’s national medical director, explains: “This is an achievable ambition which positions Britain to unlock longstanding mysteries of disease on behalf of humankind. Embracing genomics will position us at the forefront of science and make the NHS the most scientifically advanced healthcare system in the world.


“This is the start of a unique, exciting journey that will bring benefits for patients, for the NHS and for society at large.”


Life Sciences Minister George Freeman added: “Our understanding of genomics is transforming the landscape for disease diagnosis and medicines research.


“We want to make the UK the best place in the world to design and discover 21st century medicines which is why we have invested in the 100,000 Genomes Project. We also want to ensure NHS patients benefit which is why we have now selected NHS hospitals to help us sequence genomes on an unprecedented scale and bring better treatments to people with cancers and rare diseases for generations to come.”


The initiative involves collecting and decoding 100,000 human genomes – complete sets of people’s genes – that will enable scientists and doctors to understand more about specific conditions. In particular it aims to improve the prediction and prevention of disease, enable new and more precise diagnostic tests, and allow personalisation of drugs and other treatments to specific genetic variants.


The first wave of 11 designated Genomic Medicine Centres are:


• East of England NHS GMC – designated for both cancer and rare disease. Led by Cambridge University Hospitals NHS Foundation Trust


• South London NHS GMC – designated for both cancer and rare disease. Led by Guy’s and St Thomas’ NHS Foundation Trust


• North West Coast NHS GMC – designated for both cancer and rare disease. Led by Liverpool Women’s NHS Foundation Trust


• Greater Manchester NHS GMC – designated for both cancer and rare disease. Led by Central Manchester University Hospitals NHS Foundation Trust


• University College London Partners NHS GMC – designated for both cancer and rare disease. Led by Great Ormond Street Hospital NHS Foundation Trust


• North East and North Cumbria NHS GMC – designated GMC for rare disease only. Led by The Newcastle upon Tyne Hospitals NHS Foundation Trust


• Oxford NHS GMC – designated for both cancer and rare disease. Led by Oxford University Hospitals Foundation Trust


• South West Peninsula NHS GMC – designated for both cancer and rare disease. Led by Royal Devon & Exeter NHS Foundation Trust


• Wessex NHS GMC – designated for both cancer and rare disease. Led by University Hospital Southampton NHS Foundation Trust


• Imperial College Health Partners NHS GMC – designated for both cancer and rare disease. Led by Imperial College Healthcare NHS Trust


• West Midlands NHS GMC – designated for both cancer and rare disease. Led by University Hospitals Birmingham NHS Foundation Trust.


Source PMLive http://www.pmlive.com/pharma_news/nhs_set_to_deliver_world-leading_genomics_centres_625990




NHS set to deliver 'world-leading' genomics centres

Friday 19 December 2014

Care.data review raises questions


An independent review on the first stage of NHS England’s controversial care.data programme says a wide range of “unresolved” questions must be answered before it can proceed.


Privacy watchdog medConfidential has described the report as “a nail into the coffin of this rolling botch job”, and says a “fundamental reset” must take place if care.data is to proceed.


The report from the Independent Information Governance Oversight Panel, chaired by national data guardian for health and care Dame Fiona Caldicott, outlines 27 questions that it says must be answered by the care.data programme board.


It also discusses seven issues that need to be addressed by the clinical commissioning groups participating in the pathfinder phase of the programme.


The care.data programme will extract data sets from different organisations, starting with GP practices, and link them to an expanded set of Hospital Episode Statistics within the ‘safe haven’ of the Health and Social Care Information Centre.


NHS England was forced to “pause” the programme in February after medical and privacy groups objected to a public leaflet campaign that failed to include a clear account of the programme, who would receive the data, or an opt-out form for patients.


In October, clinical commissioning groups in Leeds, Blackburn, Somerset and West Hampshire were selected as care.data ‘pathfinders’ as part of a revised roll-out plan.


Participating GP practices in the CCG areas will test different communication strategies with patients. The report says clarity of both policy and communication “seems to be the area of most concern” for the programme.


“Clarity of policy and clarity of communications are both absolutely essential…the public, patients and care professionals must receive clear messages about care.data.”


It says patients need to know their data is safe, with concerns about where it will go, how it will be stored, and how and with whom it will be shared.


Questions also need to be answered about the implications of opting out and whether it will have any impact on their care, as well as what the opt-out does not cover.


The report says GPs need clarity about how they are meeting their legal responsibilities as data controllers, how the pathfinder programme will support them to meet those requirements, and the “legal and ethical implications” for GPs considering an opt-out for their entire practice.


There are also governance issues that need to be addressed, including whether the content and governance of the data set to be extracted is “understood and clear”, and how the HSCIC will communicate with patients regarding their objections.


The report says there are also a number of issues that cannot be resolved at a national level but must be dealt with by the pathfinder CCGs.


Each pathfinder must be able to demonstrate that people in their area have a “sufficient understanding” of their rights and the implications of their decision, as well as ensuring they have equal access to the opt-out process an understanding of how their data may be used.


“The national data guardian and [the panel] thinks that it would be reasonable to proceed to a data extraction in the pathfinder areas” once those questions have been answered,” the report says.


“We believe that this will provide a sufficiently robust framework within which we can be confident that patients have been reasonable informed… and are able to make choices about sharing.”


Phil Booth, the co-founder of medConfidential, told EHI the “sheer weight of questions” in the report means that care.data needs a “fundamental reset” before it can go ahead.


“They might have been thinking, ‘Oh well, we’ll cross a few Ts and dot a few Is and start rolling in January, February’, but it’s inconceivable now that it won’t be pushed back past the election.”


Booth described the report as “a nail into the coffin of this rolling botch job”, and questioned the work that NHS England has done to address initial concerns about care.data.


“If they haven’t fully resolved all of this stuff, I can see the potential for it blowing up all over again…if they don’t have answers to these questions now, what the hell have they been doing?”


In a letter to Caldicott obtained by EHI, NHS England’s director for patients and information Tim Kelsey said the organisation “very much welcomes your observations and the insight it offers us in ensuring that we get the pathfinder stage of the programme right.”


“We will come back to you in the New Year to discuss the report further once we have had the opportunity to speak with our colleagues in the pathfinder areas and to consider the questions and tests carefully.”


Source EHI 19 December 2014   Sam Sachdeva http://ehi.co.uk/news/EHI/9808/care.data-review-raises-questions



Care.data review raises questions

Thursday 18 December 2014

DanMedical appoints new senior management team and secures significant new funding to fuel innovation and growth

DanMedical appoints new senior management team and secures significant new funding to fuel innovation and growth


Peter Couldery appointed as new CEO


Oxford, UK, 18th December 201

Today, DanMedical Ltd, the leading telemedicine solutions provider has appointed a new management team and secured funding to fuel global innovation and growth opportunities in the Offshore Energy and Healthcare sectors.


DanMedical’s management team will be led by new CEO, Peter Couldery, a highly experienced business leader and Chartered Engineer. Peter will drive DanMedical’s growth and expansion.


Founder Ian Drysdale, as Chief Technical Officer will focus on the technical development and advancement of the DanMedical portfolio of products and services.


Experienced sales and marketeer Sergei Sollo is appointed as Marketing Manager to focus on maximising the marketing and communications strategy of the portfolio.


About DanMedical Ltd


Headquartered in Kingham, Oxfordshire, UK; DanMedical telemedicine products and services are based upon the D-MAS platform – clinical diagnostic and monitoring devices which include Resting ECG, Extended ECG, Pulse CO-Oximetry, Blood Pressure, Core Temperature, Spirometry and Digital Imaging Scopes, with video conferencing capability and electronic patient records all completely housed within a medical grade portable laptop.

Vital patient information can be communicated in real-time to any on-line location allowing medical support in some of the most remote locations including offshore and saturation diving chambers with full DanMedical technical support.

Currently units are in use offshore on more than 30 vessels and rigs; and in remote locations such as NHS Shetland and NHS Orkney.

Full product and service details www.danmedical.com Tel +44 (0)1608 658924


For further information and media enquiries please contact -


Sergei Sollo

Marketing Manager

DanMedical Ltd.


sergei.sollo@danmedical.com www.DanMedical.com @DanMedical


t: +44 (0)1608 658924     m +44 (0)7836 261128


DanMedical Ltd., 12 Threshers Yard, Kingham, Oxfordshire, UK OX7 6YF



DanMedical appoints new senior management team and secures significant new funding to fuel innovation and growth

Wednesday 17 December 2014

21% of patients in England can now access their medical record online

As of September 2014, 21% of patients in England have been able to access their medical records online, a significant increase on 2% this time last year.


8 December 2014 – 17:20


The number of patients able to book their appointments and request repeat prescriptions has also jumped to 91% and 88% respectively.


NHS England’s Patient Online programme team has been working closely with practices across England to ensure they have the support they need to confidently offer these online services.


As well as a national network of implementation and clinical support services, practices continue to use the recently published the Patient Online Support and Resources Guide. This guide includes guidance and practice tools developed by the Royal College of GPs, as well as materials for patients, frequently asked questions, regional and local support arrangements and much more.


Focus will now turn to those practices who aren’t offering online services, finding out what the barriers are and what we can do to help them overcome them. Please contact us with any questions or feedback.


Progress in numbers at end of September 2014:


  • 99% of general practices have the capability to allow patients to book or cancel appointments online.

  • 91% of patients are registered with general practices that offer the ability to book or cancel appointments online.  This is up from 64% at the same point in the previous year.

  • 98% of general practices have the capability to allow patients to view or order repeat prescriptions online.

  • 88% of patients are registered with general practices that offer the ability to view or order repeat prescriptions online.  This is up from 64% at the same point in the previous year.

  • 84% of general practices have the capability to allow patients to view their medical record online.

  • 21% of patients are registered with general practices that offer the ability to view their medical records online.  This is up from 2% at the same point in the previous year.             

Source NHS England http://www.england.nhs.uk/2014/12/08/patient-online-increase/



21% of patients in England can now access their medical record online

Monday 15 December 2014

Which health websites can you trust?



With online health advice ranging from the helpful to the hysterical, where should you turn when illness strikes? Health experts share the websites they recommend









Health websites
It is important to choose carefully when looking for health information online. Photograph: Guardian



Picture the moment. It is 3am and you have a really bad stomach ache. You are scared and in pain. “Time for Drs Google, Yahoo or Bing,” you think, typing your symptoms in to your favourite search engine. In England alone, there are 50,000 organisations offering web-based help in health and social care. They range from the evidence-laden to the random, the sensible to the crazed, and the helpful to the hysterical.


So how to make sense of it all? Nearly all of us – 87% in both the UK and the US – use the internet, and searching for health information is one of the most popular activities. More than 80% of internet users seek health information or advice. The information is plentiful and free: only 2% of those seeking health information online in the US, for example, pay for it. But we are obviously wary – or perhaps healthily sceptical – of what we read online. A US survey by the Pew Research Center showed that the vast majority of people still ultimately rely on a doctor or healthcare professional for medical advice, 60% also ask relatives and friends and nearly a quarter ask people with the same condition.


But what if it is that 3am scare, and everyone is asleep? Which websites can you trust, and how can you tell? A range of healthcare experts share their tips and recommendations:


The neuroscientist


Barbara Sahakian, professor of clinical neuropsychology at the University of Cambridge, says she generally recommends experts rather than individual websites. However, she singles out the National Institute for Health and Care Excellence (nice.org.uk) for general health information, the US National Institutes of Health (nih.gov) for excellent advice on mental health, alcohol and substance abuse and addiction, and the Alzheimer’s Society website (alzheimers.org.uk) for reliable information and support on dementia.


The mental health campaigner


Marion Janner, campaigner and founder of Star Wards, one of this year’s Guardian/ Observer Christmas appeal charities, recommends her organisation’s site, wardipedia.org, to anyone seeking information on mental healthcare. “It’s an online compendium of great practice on mental health wards, with over 1,000 examples of imaginative, therapeutic care contributed by staff and patients, along with the evidence base.”


The audiologist


Louise Hart, audiologist at the charity Action on Hearing Loss, recommends its website (actiononhearingloss.org.uk) for information on ringing in the ears or on hearing loss. More generally, she says, look out for Information Standard certification, which is the quality mark awarded by NHS England. Organisations with the quality mark have been filtered to ensure they pass rigorous standards. To gain certification, material has to be “accurate, accessible, impartial, balanced, evidence-based and well written”. Sites without a quality mark may still be good, but it is hard to judge. The main challenge is to work out which sites have validated and updated information, and the quality mark is currently the best available indicator for UK users.


The therapist


Sharon Schamroth, a psychodynamic therapist, says she finds reliable and practical information in dealing with cancer at cancerresearchuk.org and macmillan.org.uk. For mental health problems and finding the right practitioner for therapy and counselling, she points people to itsgoodtotalk.org.uk. Some sites, she says, may have good information, but have areas that are not relevant to UK users – such as the US based niaaa.nih.gov, which includes useful advice about alcohol dependence, but has details of US support groups and policy statements.


The GP


Carmel Mond, a London GP, suggests NHS Choices for simple, sensible advice and patient.co.uk for those who want more detail. All the experts warn that unfiltered use of the internet can cause panic and confusion. “Unmoderated chat sites make it impossible to separate the useful from the downright mad,” warns Mond.


The academic


Ian Jacobs is professor and vice president of the Faculty of Medical and Human Sciences at the University of Manchester, and a gynaecological oncologist who has campaigned to raise awareness and funding for women’s cancers. He was director of the UK trial into ovarian cancer screening which involved 200,000 women. He recommends eveappeal.org.uk for information about gynaecological cancers and ovacome.org.uk for information about ovarian cancer.


The digital marketing manager


Sam Butler, digital marketing manager at the Anthony Nolan charity, says healthtalk.org shares real-life stories of people living with different conditions, including blood cancers. “If you’re living with a health problem, it can be useful and reassuring to hear stories from others going through the same things – what the day to day reality is, as well as how other people have coped and looked after themselves,” he says.


Many websites, even responsible ones such as mumsnet.com, present a mix of fact and opinion that is hard to disentangle. And since most health content is available free of charge, all these sites must be funded somehow. Some have very obvious and intrusive advertising, which can be offputting but does enable you to see where the money is coming from. Find the funders, and you will uncover the bias. Pharmaceutical companies fund a lot of health information sites and have products to sell. So Pfizer’s leaflet on erectile dysfunction is excellent and doesn’t mention any particular drug – but it is interesting to know Pfizer makes Viagra. So given a choice, you might feel happier reading about the same subject on NHS Choices.


So surfer beware: look for a quality mark, check the content has been updated recently, make sure it is relevant to where you live and, if in doubt, ask a human being – preferably a medically trained one. Especially if the belly ache is still there in the morning.


Source The Guardian http://www.theguardian.com/lifeandstyle/2014/dec/14/which-health-websites-can-you-trust-experts-recommend








Which health websites can you trust?

Friday 12 December 2014

Digital health start-ups spin wheels



Priya Prakash, designer and founder of D4SC, speaks at the Digital Catapult’s Digital Health Pit Stop event.


15 digital health start-ups are pitching ideas for wearable tech and apps as part of a week-long “pit stop” programme arranged by a new technology and innovation centre.


The Digital Health Pit Stop event has been organised by the Digital Catapult Centre, part of the Catapult project funded by Innovate UK to establish a range of technology and innovation centres for UK businesses, scientists and engineers.


The digital health event, held in Kings Cross this week, has included a number of one-on-one sessions with experts on design, capital enterprise, healthcare and cybersecurity for companies working in digital health.


Marko Balabanovic, innovation director at the Digital Catapult Centre, told EHI the purpose of the centre is to “accelerate” start-ups and other projects to encourage commercial success while making the best use of the existing UK research base.


“We’re very much focussed on data innovation: people have more devices, there are more sensors whether you’re in cities, people’s houses or industrial environments, and that means there’s a lot of data creating economic opportunities for people to work on things.”


Balabanovic said digital health’s appeal as the first official event for the centre is due to the difficulties that start-ups in the sector may face due to its complexity, and the chance to open up new marketplaces in the “vibrant” field.


“It will never be the case that everyone’s health records are open, they’ll be closed, but there are opportunities there to take advantage of some data and analytics and open things up in a trusted way.”


He said start-ups wanting to get their products into the NHS face distinct obstacles, including dealing with procurement processes and building clinical evidence.


A psychiatrist from the South London and Maudsley NHS Foundation Trust spoke to the start-ups about working on the myhealthlocker personal health records project, giving “quite pragmatic advice” about how to work with the NHS.


Balabanovic said start-ups taking part in the event include a company developing non-contact vital signs technology and another developing a clinical noting solution for mobile devices.


“It’s a very inspiring group, and I think the wonderful thing is that I want them all to succeed because they’re improving people’s lives.”


The companies will pitch their products at an event today, with a keynote talk from Professor Zen Chu of MIT, founding CEO of 3 healthcare companies and MIT Hacking Medicine, and a panel of judges awarding prizes for the most innovative companies.


Source EHI 12 December 2014   Sam Sachdeva http://www.ehi.co.uk/news/industry/9789/digital-health-start-ups-spin-wheels



Digital health start-ups spin wheels

Thursday 11 December 2014

Broadmoor to test camera that remotely monitors vital signs

Staff walking around Broadmoor Hospital

Broadmoor is a high-security psychiatric hospital which cares for 200 men

Broadmoor is to test a camera that remotely monitors patients’ vital signs such as heart and breathing rate.


It is hoped the device will alert staff early to any attempts to self-harm and spare patients disruptive night checks.


Testing with the remote monitoring devices will begin in the new year, initially with volunteer staff.


If successful, the technology may be extended to other settings, including prisons, care homes, and even car dashboards.



I think there’s an exciting opportunity here for Broadmoor to lead with current technological developments in this entire field of contactless monitoring.”


Dr Amlan Basu Clinical director, Broadmoor


Broadmoor is notorious for housing violent criminals. But it is a high-security psychiatric hospital, not a prison, taking care of 200 men with severe mental health problems including paranoia, schizophrenia or personality disorders.


It is now helping to develop a new system of patient surveillance, using cameras, or “optical monitors”, in secure rooms to detect patients’ vital signs – initially their breathing and heart rates.


Night-time checks


At the moment staff have to carry out routine checks on patients up to four times an hour through the night. This often entails flashing a torch, switching on a light or entering a secure room.


The clinical director at Broadmoor, consultant forensic psychiatrist Dr Amlan Basu, says if this job could be done by cameras, it would allow staff to concentrate on the patients who need help most.


“My hope is that by achieving accuracy of data and reassurance, nursing staff will be freed up to perhaps spend their time more effectively by actually engaging with patients rather than having to walk round a ward checking on patients being alive and well.”


A patient I spoke to, who has been at Broadmoor for nearly four years, told me the night-time checks were frustrating and disturbing.


Inside Broadmoor Hospital

Patients in the units at Broadmoor have to be checked on by staff several times an hour every night

He welcomed the idea behind the cameras, though he felt some patients may not want them.


“I think it’s a better solution than staff going around and turning the lights on at night time and checking on people every half an hour because you’re in the dark and they don’t know if you’re breathing or not.


“Turning on the light, they’ve got to wait to see if you’re breathing – but an infra-red camera that films you and can see is better than the human eye.”


Broadmoor is working with the hi-tech firm Oxehealth, which has already tested this technology alongside conventional monitors with kidney patients and premature babies at Oxford University Hospitals Trust.


The initial results – peer-reviewed and published – were good.


Microblushes


The camera works by monitoring chest movement to estimate the breathing rate.


It also detects subtle changes in skin colour on the face – or “microblushes” – produced by movement of the blood, driven by pulse-beats. Then – using sophisticated algorithms – it calculates the heart rate.


The device – which works in bright light or darkness – is being developed to identify blood oxygen levels, blood pressure and the patient’s temperature.


Oxehealth’s chief executive, Jonathan Chevallier, says there is no problem with privacy because the camera does not send images.


Broadmoor Hospital sign

He suggests the technology has great potential for use in the home.


“If you’re over the age of 65 you probably have friends who’ve had a stroke.


“You probably don’t spend too much time thinking about it because it’s a bit scary, but if you knew there was a technology you could have in your home, silently monitoring you, just checking you’re OK, and it’s going to detect when you’re developing an irregular heartbeat so you can see your doctor and avoid a stroke, I think that’s a massive benefit.”


Placed discreetly in the wall of a secure room, the camera will be tried out with staff volunteers at Broadmoor in the new year.


Then, if all goes well, it will be tested with patients who have given their consent.


A senior nurse at Broadmoor, Neil Ragoobar, says many will welcome the opportunity for undisrupted sleep.


He says this type of remote monitoring should help relations between staff and patients and improve safety.


“If they know they’ve got a patient who’s a chronic self-harmer and those vital signs are going outside of the normal parameters, it alerts the nurse that there could be something going on here, under the covers or whatever, and they can investigate before it becomes a life-threatening situation.”


Source BBC News/Health http://www.bbc.co.uk/news/health-30434925



Broadmoor to test camera that remotely monitors vital signs

Wednesday 10 December 2014

Pharmacy should move to a ‘wellness-based’ service

There’s a greater preventative role for pharmacists, says RPS

Ash Soni Royal Pharmaceutical Society

Pharmacists can play a far greater role when it comes to preventative medicine and the profession should move from being part of an illness-based service to being one based on wellness.That was the message from the president of the UK’s Royal Pharmaceutical Society (RPS) Ash Soni when he appeared at an event put on by Merck Consumer Health last month.

Soni, who is the clinical network lead for Lambeth Clinical Commissioning Group and practices as a pharmacist himself in London, said that, with current shortages of doctors and nurses across Europe, pharmacy was poised to play a wider role in the region’s healthcare ecosystem.


“Everybody, everywhere – globally – says that pharmacy is underutilised. It is an opportunity that is being missed – the challenge is working out how we pay for it,” said Soni (pictured above).


He suggested that an expansion of pharmacists’ roles could see them take on a prescribing role for certain conditions.


“I don’t think the source of the prescription, going forwards, will necessarily be the GP – pharmacists will carry much more responsibility in how we manage the care of patients and the public. One of the big challenges for governments is to move from what has historically been an illness-based service to a wellness-based service.”


Wellness requires you to start to intervene with people who are healthy and well, he added – pointing out that this is something for which pharmacy is already well-placed.


But thinking ahead to how such changes could effect relations with pharma, Soni warned that the industry would have to be careful not to repeat past mistakes.


“Historically the pharmaceutical industry used to talk to doctors about products and drove the markets in certain ways and that came to be seen as inappropriate – and there’s been more and more stepping away and talking to doctors and about therapeutic benefits and the evidence base to support what is going to be used.”


He concluded: “There are some real opportunities for industry and the profession, but the challenge will be for the industry to support the profession in its development and not necessarily to do it in a way that is product specific, but is disease and wellness orientated.”


Source PMLive http://www.pmlive.com/pharma_news/pharmacy_should_move_to_a_wellness-based_service_622401




Pharmacy should move to a ‘wellness-based’ service

Monday 8 December 2014

US doctors support digital health technology

Mobile devices and apps find favour in new survey

Doctor healthcare professional HCP iPad eHealth


A majority of doctors in the US think that patients who use mobile devices as part of their healthcare can help clinicians better coordinate care, according to a new report.


PwC found that some 79% of physicians – and almost half of the general public – believe that a patient’s use of mobile technology will help his or her caregivers to work more as a team.


But the consultants said there was still a need to implement more consumer-friendly technology and that the next few years would be crucial ones for the development of digital health.


Daniel Garrett, health information technology practice leader at PwC US, said: “Digitally-enabled care is no longer nice-to-have, it’s fundamental for delivering high quality care. Just as the banking and retail sectors today use data and technology to improve efficiency, raise quality and expand services.”


The firm said its Healthcare Delivery of the Future report, which is based on a survey of 1,000 industry leaders, physicians, nurse practitioners and physician’s assistants, suggests an increased openness among clinicians towards using digital technology.


In particular the report found support for:


  • Putting diagnostic testing of basic conditions into the hands of patients – 42% of physicians said they were comfortable relying on at-home test results to prescribe medication

  • Increasing online interactions between patients and their clinicians – half of physicians said that e-visits could replace more than 10% of in-office patient visits, and nearly as many consumers indicated they would communicate with caregivers online

  • Promoting self-management of chronic disease via health apps: around two-thirds of physicians said they would prescribe an app to help patients manage chronic diseases such as diabetes.

Simon Samaha, principal at PwC, said: “The adoption and integration of digital technology with existing healthcare processes has not yet fulfilled its potential to transform care and value for patients.


 


“The next five years will be critical, with leaders emerging from those who use digital technology to innovate and revamp the interactions between consumers, providers and payers.”


PwC said that health plans, hospitals and pharma are all anticipating major shifts in how care is delivered, but data-sharing, consumer consent, privacy and security, fragmented workflows and digital investment still form barriers to the technology’s adoption.


Source PMLive http://www.pmlive.com/blogs/digital_intelligence/archive/2014/december/us_doctors_support_digital_health_technology




US doctors support digital health technology

Friday 5 December 2014

Volunteers sought for Code4Health pilots


NHS England is looking for NHS trusts and other healthcare providers to act as pilot sites for its re-animated Code4Health programme.


The pilots form part a plan to establish a “franchisee” model, with organisations providing virtual and physical Code4Health courses that lead to recognised qualifications.


Peter Coates, NHS England’s open source programme manager, has expanded on plans for Code4Health at a number of recent open source events.


In March, EHI reported that Code4Health was being given a new lease of life after news on the initiative to teach 50,000 clinicians to code dried up in the latter half of 2013.


At the time, NHS England’s head of business systems Richard Jefferson said he would be heading up Code4Health, running alongside its open source programme, with plans to redefine and potentially broaden its objectives.


At a recent meeting, Coates described the programme as “an important part of the whole ecosystem” as a development and learning platform for clinicians and developers.


“To me, it’s all about developers, designers and clinicians having a better understanding of each other’s worlds and understanding the possible.”


Coates said part of the Code4Health programme will be based on creating a “self-sustaining community” of franchisees, such as trusts, clinical commissioning groups, and GP organisations, to run a set of courses and activities on digital health and health informatics.


He said the first courses are likely to be on “building a healthcare app in a day” and “data visualisation in a day”, with other potential subjects to include an introduction to open source and to open clinical content health records.


NHS England will commission the development of an exemplar set of courses, which are expected to lead to recognised vocational and academic qualifications.


Coates said the Code4Health team will look for two to three franchises in each region to run several training courses for doctors and nurses.


There are plans to run small pilots before 31 March with “a couple of hundred people” on courses across the country, with feedback from the participants used to inform future plans for Code4Health.


The Code4Health programme will also use the HANDI Health Open Platform Demonstrator, developed to provide a testing and development environment to build apps, using anonymised test data provided by the Leeds Health Innovation Lab in an environment simulating realistic digital healthcare ecosystems.


Coates said Code4Health has been given free licences by a number of suppliers for testing and development purposes, allowing users to experiment with different open source electronic health records, knowledge repositories and APIs to build trial apps.


“The concept is really that in the Code4Health learning sessions, clinicians can come together with developers, identify the systems they’re using in the current trusts, and experiment with them and develop new functionality and new apps that they can potentially use in the real world.”


Coates said the platform is “effectively still in alpha version”, but is being used by Fivium to develop an open source electronic prescribing system.


When announced by Kelsey, the Code4Health programme was going to be based on the US organisation ‘Code for America’, created to teach local government workers how to create apps and services using open source data.


Source EHI 4 December 2014   Sam Sachdeva http://ehi.co.uk/news/EHI/9778/volunteers-sought-for-code4health-pilots



Volunteers sought for Code4Health pilots

Thursday 4 December 2014

New health money: solution or sticking plaster?


A stethoscope on top of patient's files

It will take more than money to improve primary care, say GPs

There has been a cautious welcome from many parts of the NHS for the government’s announcement of new money for the next financial year.


Most are relieved that a painful financial squeeze has been headed off. Equally, they are aware that a lukewarm response to ministers finding more money for health at a time of tough controls on other areas of Whitehall would not look good.


But from one influential group representing GPs, pharmacies and other organisations in primary care came an interesting perspective – it’s not all about the money.


The NHS Alliance is chaired by Dr Michael Dixon and, in a letter to The Guardian newspaper, he sets out his view that a fundamental rethink of community medicine and the role of GPs is needed.


‘Tipping point’Dr Dixon is quick to welcome the Autumn Statement’s commitment to new investment in general practice. This will see £300m a year, culled from fines paid by banks for foreign exchange misdemeanours, made available for four years. But he believes there are deep-set problems which cannot be solved by cash on its own.


In his letter he says: “GPs are on their knees, new GPs are scarce… general practice is at a tipping point.”


He urges doctors to stop working up to 14-hour days as it affects their ability to provide consistent patient care. And he talks of a “developing fracture between patient and doctor due to a mismatch in expectation and reality”.


In other words, the patient has a duty along with health professionals to help reshape primary care as “responsive and responsible citizens”.


George Osborne

Chancellor George Osborne says the NHS will get an extra £2bn a year

Dr Dixon’s wish list is headed by a call for GPs to abandon silos and reach out to colleagues such as pharmacists and hospital consultants. The edges between primary and secondary care should blur and be dissolved, he says. He believes each local area should have a “community health connector” to bring health, social care and local authority sectors together.



The cheque is in the post from the chancellor – but it won’t on its own provide the answers”



It may sound utopian but the NHS Alliance perspective seems in tune with the five-year view for NHS England set out by Simon Stevens. Breaking down barriers, acting locally and integrating care are buzzwords which have been heard frequently in the debate about the document since it was published in October. Deciding what that means in practice is work in progress.


While big thoughts are batted around in the corridors of NHS power, the financial reality facing some health economies was graphically illustrated with news from one of England’s largest clinical commissioning groups (CCGs).


The Northern, Eastern and Western Devon CCG has announced temporary restrictions on some types or surgery as it grapples with a mounting financial deficit. Severely obese patients have been told to lose weight or face missing out on routine surgery. Smokers have been instructed to give up at least eight weeks before surgical procedures. Certain types of shoulder surgery will be limited and there will be restrictions on additional hearing aids.


These measures taken in some parts of Devon may or may not represent a “canary in the coal mine”. The moves affecting obese patients and smokers have precedents in other areas. But they strengthen the case for urgent new thinking.


The cheque is in the post from the chancellor – but it won’t on its own provide the answers.






Source BBC News/Health http://www.bbc.co.uk/news/health-30314099



New health money: solution or sticking plaster?

Wednesday 3 December 2014

Hunt says £2 billion is for 'change'



Health secretary Jeremy Hunt


Health secretary Jeremy Hunt has said the £2 billion ‘additional’ funding that Chancellor George Osborne will announce in his autumn statement will be used to support change in the NHS.


Speaking at a Reform conference, Hunt said the coalition was behind the ‘Five Year Forward View’ drawn up by Simon Stevens, the chief executive of NHS England, to try and close a projected funding gap of £30 billion by 2020-21.


“This week, the government, the Chancellor, have said ‘ we accept this plan’ and we are backing it with the money the NHS is asking for next year; which is the only year for which a spending review is in place,” he said.


Osborne’s announcement was widely trailed at the weekend, but the headline figure of £2 billion has been challenged by Labour, which accused him of ‘recycling’ cash.


While the money is new in the sense that it was not previously allocated to the NHS, around £750m is coming from an under-spend in the commissioning system and “non-frontline” savings.


Around £200m has already been earmarked for bailing out trusts in financial distress. However, speakers at the think-tank conference warned it was essential that any new money did more than this.


Sir David Dalton, the chief executive of Salford Royal NHS Foundation Trust, who is about to deliver a report on new models for smaller hospitals, said it would be a “missed opportunity” if it was “soaked up” in bailing out organisations in difficulty.


Hunt said change was essential if the NHS was going to cope with an ageing population, which he described as “the political challenge of our generation.”


Reprising other recent speeches, he said his ‘four pillars’ for the NHS of the future were a “strong economy”, “better care for people with long-term conditions”, the faster uptake of technology, and better “accountability and transparency”.


He said that to create “stability”, the government was looking at introducing “multi-year planning and commissioning”; while a move to introduce costing for individual patients would help clinical commissioners to invest in innovation by making clear any cost benefit.


He also argued that initiatives such as the recent release of “4,000 pieces of data” onto the MyNHS website, would help staff and patients to see how the NHS was doing, and support a shift from “top-down management” to “peer review” of services.


Speaking earlier in the afternoon, shadow health secretary Andy Burnham outlined similar ideas about the direction of travel for health and social care, and the mechanisms for getting there.


He said Labour was on a “ten year journey” to create an integrated health and social care system, and that he wanted a personalised service, focused on caring for individuals in their home whenever possible.


He said his drivers for achieving this would be a ‘year of care’ tariff to pay for both health and social care that would incentivise prevention, and new rights in the NHS constitution to encourage personalisation.


Returning to the £2 billion due to be announced today, Burnham also warned it was essential that it was not sucked into acute care and that any further increases were not paid for by further cuts to social care. If this happened, he warned, patients would become “stuck” in increasingly “dysfunctional” hospitals.


Despite the near-universal support for integration at #reformhealth, speakers were asked whether it could really deliver the scale of savings needed by 2020-21.


Tony Lambert of Monitor said he hoped it could; while noting that the Five Year Forward View’s plans “depend on continued investment in the next Parliament” that is, as yet, unknown. The plan itself estimates that about £8 billion of additional funding will be needed.


Ian Dodge, who became national director of commissioning at NHS England in July said he was “optimistic”; and that the NHS might do better.


“We have built in an efficiency kicker that suggest if we get it right the increase in efficiency could increase from 2% to 3% towards the end of the [next] Parliament,” he said.


Source EHI 3 December 2014   Lyn Whitfield; http://www.ehi.co.uk/news/EHI/9775/hunt-says-£2-billion-is-for-’change’



Hunt says £2 billion is for 'change'

Monday 1 December 2014

Osborne 'finds £2 billion for NHS'



Chancellor George Osborne


Chancellor George Osborne is due to back the ‘Five Year Forward View’ to reform the NHS in his autumn statement this week.


According to reports in a number of Sunday newspapers, Osborne will announce an additional £2 billion of funding for the health service next year, and present it as a down payment on change.


NHS England’s chief executive, Simon Stevens, launched his Five Year Forward View in October, calling for more action on public health and new models of service delivery to help close a £30 billion gap between funding, costs and demand that could otherwise open up by 2020-21.


The plan had a significant IT component, which has been backed up by the commissioning board’s IT framework, ‘Personalised Health and Care 2020’.


This calls for a mix of national and local investment in IT to support hospital efficiency and integrated working, and new technology – including ‘kitemarked’ apps – to encourage the public to get more involved with their own health and care.


Osborne told the Telegraph that he had held talks with Stevens, and that he would back the reforms. “I endorse this Forward View as a way to deliver a world-class and universal NHS that is sustainable for the long term,” he said.


However, the move clearly has a political component, with trusts already in deficit, a winter crisis in the offing, and opposition parties promising additional funding for the health service.


Shadow health secretary Andy Burnham responded to the pre-coverage of the autumn statement by saying that Labour had a “fully funded” plan to give the NHS £2.5 billion a year over the coalition’s spending plans.


The Financial Times put some additional detail on Osborne’s plans, saying that £200m would be spent on supporting the most financially challenged local areas, and £1.5 billion on the NHS more generally.


Although more than half of the headline £2 billion will come from the Treasury, the FT also reported that around £750m will come from an under-spend by the commissioning system, and “non-frontline” savings.


EHI reported last week that there is concern that this may include some of the money immediately promised for NHS IT through the tech funds.


The announcement of which trusts have won money from the second round, or ‘Integrated Digital Care Fund’, has been repeatedly delayed; with NHS England saying it is “imminent but not confirmed” for almost a month.


Think-tanks have welcomed Osborne’s move. Nigel Edwards, chief executive of the Nuffield Trust, which has joined the King’s Fund in warning of an imminent crisis in the NHS, and the need for pump-priming to support reform, said it would “take the immediate heat off the system.”


However, he pointed out that the National Audit Office has concluded that the NHS as a whole may not finish this year in surplus, so future administrations will not be able to continue to find “new” money for the health service from under-spends.


Meanwhile, the Institute for Fiscal Studies pointed out that if the NHS continued to be protected other areas of public spending would face “staggeringly big” cuts if the government also continued with its deficit reduction plans.


Source EHI 1 December 2014  http://www.ehi.co.uk/news/EHI/9772/osborne-’finds-£2-billion-for-nhs’



Osborne 'finds £2 billion for NHS'