Government crackdown on doctor-pharma payments

Physicians could face jail over accepting some industry gifts under new plans

 

British health secretary Jeremy Hunt is to create tough new rules designed to criminalise certain gift and financial payments between doctors and pharma.

Hunt has said that new rules, designed to come into force from next year, will force senior medical staff to declare all gifts and hospitality they receive from drug companies – or face the sack and the threat of jail.

In addition, all hospitals and GP groups will be required to keep a register of hospitality and gifts from pharma firms to health service staff.

The so-called Sunshine law will build on new European rules also set to come into force next year, as well as existing rules from the ABPI that already publish aggregate payments between doctors in the UK and pharma.

The problem of pharma paying doctors incentives to help prescribe medicines is one that has been diminishing over the past 20 years.

But this month an investigation by the British newspaper The Telegraph found a number of senior NHS staff allegedly willing to accept thousands of pounds to allow pharma sales reps access to key health service managers.

Hunt said: “The Telegraph‘s investigation suggested that some NHS staff and professionals making these decisions may have been influenced by extravagant hospitality.

“It’s hard not to conclude that some sales reps have ben ripping the NHS off, and diverting taxpayers’ money away from patient care.”

The ABPI said it welcomes Hunt’s announcement of a new ‘Sunshine Rule’.

Dr Virginia Acha, ABPI’s executive director – Research, Medical and Innovation, said: “We would welcome the opportunity to work with the Department of Health and NHS England as plans for the ‘Sunshine Rule’ develop, to ensure that we maximise our combined efforts on disclosure for the benefit of patients and the public.

“It appears that whilst declarations of gifts and hospitality made under the proposed Sunshine Rule signal a common ambition for greater transparency in our relationships, it will cover just a small proportion of the important interaction between industry and HCPs in comparison to our own disclosure requirements.

“For that common ambition for greater transparency to really improve relationships between healthcare professionals and industry, we also need to align on the great value of those relationships to deliver advances in science and treatment for patients, including research.  We have always maintained these interactions are a critical part of advancing improved healthcare outcomes for patients within appropriate and transparent governance frameworks.”

Source PMLive http://www.pmlive.com/pharma_news/government_crackdown_on_doctor-pharma_payments_805070

Government crackdown on doctor-pharma payments

VP of digital innovation at Decision Resources Group joins Google's healthcare advisory board

Decision Resources analyst to help drive innovation

Google’s healthcare advisory board has selected Monique Levy, vice president of digital innovation at Decision Resources Group, to join its team.

Levy, healthcare, media and technology analyst, will provide insights on ways to improve and change the healthcare industry.

She said: “I’m honoured to be part of this distinguished group of industry leaders and work more closely with Google to help drive innovation in healthcare.“

Technology – from data, to experiences and devices – will play a central role in the transformation of healthcare to a value, patient-centred and outcomes driven system.”

Google’s health care advisory board was formed in 2013 with the goal of gaining a better understanding of problems faced by healthcare consumers and providers and in turn offer feedback, ideas and solutions.

Ryan Olohan, national industry director of healthcare at Google, said: “Monique has been a thought leader in the industry and a valued partner to Google for many years so of course our team is very excited to have her join the board.

”The board itself consists of top pharmaceutical, media, and agency executives as well as prominent thought leaders who all assist in Google’s numerous health initiatives.

Healthcare has a central place in Google’s new holding company Alphabet – created just last week to create a leaner organisation for the technology giant.

Source PMLive http://www.pmlive.com/pharma_appointments/monique_levy_joins_googles_healthcare_advisory_board_802726

VP of digital innovation at Decision Resources Group joins Google's healthcare advisory board

MRI scans can deliver cancer therapy

A hospital scan normally used to detect cancer could be used to steer tumour killing treatments to hard-to-reach targets in the body, say scientists.

The UK team at Sheffield University deployed the magnetic power of MRI scans to control the movement of a specially designed injectable cancer therapy.

Early trials in mice suggest the novel delivery method works.

But years more of studies are needed before it could be used in patients.

The hope is it will revolutionise the way doctors treat cancers that are tricky or impossible to remove surgically – tumours in the brain and spine and cancers that have spread around the body, for example.

Seek and destroy

A benefit of the new MRI method is it appears to hone in on cancerous cells with little collateral damage to the surrounding healthy tissue, which should mean fewer side effects for patients.

The scientists tested the method in mice with prostate cancer that had also spread to the lung.

They used a special cancer medicine – human white blood cells modified to carry a cancer-killing virus – to treat the mice.

It’s a fascinating idea – but more studies are needed to see if this approach could work in people

Dr Nick Peel of Cancer Research UK

Before injecting the treatment, they “magnetised” it by loading it with microscopic iron particles.

Once injected into the mice, the researchers were able to use the strong magnets in the MRI scanner to tightly control where the drug travelled.

Dr Munitta Muthana and colleagues say the technique is promising not least because it combines treatment and equipment that is readily available.

Dr Muthana told the BBC: “We need to do more studies first, but hopefully we will be able to start testing it in patients.

“We’d need to check that clinical scanners are strong enough…and if we can reduce the length of time that a patient would need to be in the scanner. The treatment took 30 minutes to a hour in mice.

“An advantage of using MRI is that you can also track where the treatment is going. It could be really useful,” she said.

Dr Nick Peel, senior science information officer at Cancer Research UK, said: “Using viruses to kill tumour cells is one of many ways researchers are using the immune system to attack cancer. But getting the virus precisely on target is a real challenge.

“This early research in mice suggests that using a magnetic field from the MRI scanner could help propel the virus towards cancer tumours using metal nanoparticles.

“It’s a fascinating idea – but more studies are needed to see if this approach could work in people, especially for tumours located deeper within the body. And we need even more research to show whether this could actually improve treatment.”

Source BBC News/Health  http://www.bbc.co.uk/news/health-33957105

By Michelle RobertsHealth editor, BBC News online

MRI scans can deliver cancer therapy

Call to punish GPs over antibiotics

“Soft-touch” and “hazardous” doctors should be disciplined for prescribing too many antibiotics, a leading NHS figure says.

The National Institute for Health and Care Excellence’s Prof Mark Baker said 10 million prescriptions a year in England were inappropriate.

He said regulators need to deal with overprescribing doctors who failed to change their ways.

The Royal College of GPs said the call was “counter-productive and unhelpful”.

There is universal consensus that the very basis of modern medicine is under threat due to rising numbers of infections that are resistant to drugs.

The “antibiotic apocalypse” not only means that long-forgotten infections could kill again, but jeopardises procedures including surgery and chemotherapy.

Using antibiotics inappropriately for sore throats and colds increases the risk of resistance. Yet the number of prescriptions continues to rise.

Some bacteria are becoming resistant to our best drugs

NICE has prepared fresh guidelines on antibiotic prescribing for the NHS in England, which can be adopted by other parts of the UK.

The guidelines acknowledge that there is huge pressure from some patients for the drugs.

Antibiotics – what are they good for?

• Antibiotics can treat bacterial infections, but they are useless against viruses or other types of infection


• Colds and most coughs and sore throats are caused by viruses


• And our bodies are good at fighting off many common infections, including ear infections, on their own


• Your doctor should only prescribe antibiotics when you need them, for example for a kidney infection or pneumonia. Antibiotics may be life-saving for infections such as meningitis


• By not using them unnecessarily, they are more likely to work when we need them


• You could talk to your pharmacist or GP if you want to learn more

Prof Baker even said some people were “addicted” to the idea of getting antibiotics, even for conditions that would clear up on their own.

He added 97% of patients who asked for antibiotics ended up getting them, often by identifying a “soft-touch” doctor.

The guidelines say doctors should tell patients when antibiotics are inappropriate and refuse to write prescriptions.

Prof Mark Baker, director of the organisation’s centre for clinical practice, said: “We are proposing that evidence is collected so the finger can be pointed at people who are a soft touch.”

He said antibiotics could cause more harm than good in some patients, so overprescribing was “really hazardous practice”.

And, he said, doctors should be encouraged to change their habits. But ultimately some cases should be dealt with by the General Medical Council, which has the power to withdraw a doctor’s right to practise, “if necessary”.

NICE admits that if previous guidelines on respiratory tract infections, which include colds, were actually followed then prescriptions would be 22% lower.

The latest rules for doctors should cut the 42 million prescriptions given each year by around a quarter.

Dr Tim Ballard, from the Royal College of GPs, said the focus needed to be on “societal change” – not doctors.

He said: “Any suggestion that hard-pressed GPs – who are already trying to do their jobs in increasingly difficult circumstances – will be reported to the regulator is counter-productive and unhelpful.”

Case study

Robert, from Dorset, says some doctors are too restrictive.

“My daughter was ill for many weeks because the doctor refused an antibiotic.

“She was very poorly and the doctor said it was just viral and told us to go away. We took her back again and got the same response. We took her for a third time and asked him to test her mucus. He phoned us – rather embarrassed – to say that she had pneumonia.

“He prescribed her antibiotics and she got better quite quickly.

“Weeks of needless suffering!

“I’m sure he was under pressure not to prescribe antibiotics.”

NICE will be publishing guidelines on educating the public next year.

Other recommendations include the use of “delayed prescribing” where a patient can only use a prescription if his condition gets worse and creating “antimicrobial stewards” who identify high levels of prescribing.

Niall Dickson, the chief executive of the General Medical Council, said doctors should reflect on their prescribing habits as part of an annual appraisal.

He said “doctors can, and do, face sanctions for mis-prescribing.” But the message is “more about changing the norms of practice generally than pursuing individual doctors”.

Source BBC News/Health http://www.bbc.co.uk/news/health-33961241 

By James Gallagher Health editor, BBC News website

Call to punish GPs over antibiotics

Healthcare gets more independence in Google restructuring

New ‘Alphabet’ company will put tech giant’s health ventures centre-stage

Google is re-organising to create a leaner organisation, and its healthcare operations have a central place in the new structure.

The technology giant has created an over-arching holding company called Alphabet that will be run by Google founders Larry Page and Sergey Brin, while Google itself becomes a subsidiary with Sundar Pichai serving as its chief executive.

Google’s life science research arm and pharma-like unit Calico – as well as other newer ‘moon shot’ ventures such as technology research unit Google X – will now operate independently of the Internet arm, which generates most of the company’s $60bn annual revenues.

Page cited healthcare specifically in a blog post about the new strategy, saying that it “allows us more management scale, as we can run things independently that aren’t very related.”

The company’s broad push into new business areas such as healthcare has raised eyebrows among some investors, who have expressed concerns that the company could take its eye off its core business and damage profitability.

The latest move may be a reaction to that but could also reflect a desire by the founders to retain some of the fast-moving, independent spirit that served Google so well in the early years.

“We’ve long believed that over time companies tend to get comfortable doing the same thing, just making incremental change,” writes Page.

“But in the technology industry, where revolutionary ideas drive the next big growth areas, you need to be a bit uncomfortable to stay relevant.”

Google certainly shows no sign of reining in its push into healthcare. The life sciences division responsible for projects such as the glucose-sensing contact lens signed a new agreement this week with DexCom to develop a new range of continuous glucose-monitoring products.

There have also been mutterings about a lack of information about the amount of money being invested into the new ventures, and the new structure will inject some more transparency into the company’s affairs.

For the healthcare units – with development timelines that typically stretch well beyond those expected by shareholders used to investing in the IT sector – that could prove to be a little uncomfortable. However, in the near-term Google is only planning to report two revenue streams – Google and Alphabet (everything else) – and is unlikely to drill down to the details of its speculative ventures.

It will also be interesting to see whether the new structure and transparency, whilst giving the healthcare units more independence, might also encourage them to work more traditionally within their areas of focus. Could the individual units perhaps lose some of the innovative miasma that comes from bringing scientists from different disciplines closer together?

The new structure will be introduced gradually over the coming months, according to Google.

Source PMLive http://www.pmlive.com/pharma_news/healthcare_gets_more_independence_in_google_restructuring_796068

Healthcare gets more independence in Google restructuring

Digital NHS survey

More than two-thirds of British adults think the NHS should use technology more to increase efficiency and improve patient outcomes

Survey reveals NHS England not on target to meet 2020 Vision commitment, with only 4% of adults currently able to access their health records online

10 August 2015 – More than two-thirds (68%) of British adults believe that the NHS could and should use technology more in order to increase efficiency, improve patient outcomes and raise the overall patient experience, according to online research carried out by YouGov on behalf of Trustmarque. However, the research has revealed that NHS England isn’t on target to meet the Government’s commitment to give everybody online access to their GP records by 2015. Indeed, 96% of respondents stated they either didn’t have online access to all of their health records, or were unaware of whether they did or not.

The findings also highlighted that the inability of health professionals to share information effectively was affecting patient care and efficiency. Almost two-fifths (39%) of adults said they or someone they knew had to provide health professionals (such as GPs, pharmacists, hospital workers etc.) with the same medical information on more than one occasion in the last 12 months. Meanwhile, over a quarter (28%) stated they or someone they knew had experienced a delay in receiving care due to health professionals not sharing information.

“The NHS is under constant pressure to reduce costs while at the same time ensuring clinical excellence. There is no doubt that technology can play a significant role in meeting these objectives, but these survey findings reveal that that there is a lot of work to be done if the 2020 Vision is to be met,” said Angelo Di Ventura, Director at Trustmarque. “Implementing and managing the technology that underpins the transformation of the NHS is no simple task. Data should be available in different formats, for different users in different locations. However, many NHS systems have not been set up for this type of access, preventing health professionals from accessing the information they want, when they need it.”

Citizens in favour of digital technology when it comes to appointment management

The survey then went on to look at how citizens can manage and book their appointments online. Interestingly, 40% of adults didn’t think they were able to make a GP, hospital consultation or hospital test appointment online. More than half of respondents (54%) thought they could book a GP appointment online, compared to only 12% for both hospital consultations and hospital scans/tests.

At a time when the NHS reports missed GP appointments have been estimated to cost in excess of £162m each year and 6.9 million outpatient hospital appointments are missed annually, it is clear that technology can play a role in helping reduce this number. When asked how they receive appointment reminders, 32% of adults said they received them by text, 25% were reminded on the phone and 22% received reminders in the post. Interestingly only 5% said they received reminders via email. However, when asked how they would prefer to receive reminders, 58% of respondents said text message, followed by email (36%), phone (20%) and post (17%). This indicates that British adults surveyed online are in favour of digital channels which can help improve appointment attendee rates.

Citizens want to interact in different ways

When asked, nearly 1 in 2 adults (48%) said they would support the NHS giving patients the option of ‘virtual consultations’ over video links where appropriate. In addition, the majority (72%) of respondents said they would like to be able to communicate with health professionals outside of formal appointments; with phone (40%) and email (35%) being the most popular options. The survey also highlighted that nearly half (49%) of adults surveyed online have used online healthcare information to identify and diagnose systems or suggest courses of action; 28% stated they would use such services more often if more information was readily available. Providing such services could create considerable efficiency benefits for the NHS, as well as offering greater convenience to patients.

More apps and wearables please

The online survey revealed that only 10% of British adults had used a mobile health app to help them monitor and manage their health. However, 76% stated that they thought the NHS should offer or approve health apps. Booking appointments (47%), managing prescriptions (42%) and diet/exercise tracking and advice (38%) were cited as the most popular services that should be offered via a mobile app. 81% of respondents said they would like to see more connected and wearable devices in healthcare. Here, the ability to monitor vulnerable people (50%), monitor patients at home (44%) and help patients follow diet and exercise regimes (39%) were the most popular potential applications of the technology.

“New technology innovations are placing existing NHS infrastructure under pressure, both in terms of IT systems and people. At the same time NHS-wide initiatives, such as the drive towards the ‘paperless’ NHS, are further adding to the load. However, it is clear that UK adults want greater access to digital healthcare services and in the long run this promises to increase efficiencies and improve patient care. It’s imperative that every penny spent in the NHS represents the best value possible, which means working with technology partners that can help deliver this value, while driving the organisational transformation that will underpin an improved patient experience,” added Di Ventura.

The full ‘Digital NHS Healthcheck: The Citizens’ View’ report can be downloaded at http://www.trustmarque.com/report-the-digital-nhs-healthcheck-citizens-view

* All figures, unless otherwise stated, are from YouGov Plc. Total sample size was 2,010 adults. Fieldwork was undertaken between 17^th and 20^th July 2015. The survey was carried out online. The figures have been weighted and are representative of all GB adults (aged 18+).

Source Trustmarque http://www.trustmarque.com/digital-nhs-survey/

Digital NHS survey

GET Funded: A Practical Guide for Digital Health SMEs

The EU funded GET project delivers four high-impact services to digital Health SMEs and entrepreneurs in order to boost their growth and move them to the next level of competitiveness. The Get Funded service is designed for SMEs looking for follow up funding (typically between 0.5-2M€) and provides them with training, resources and networking opportunities with investors at the European level. The Get Funded practical guide was written for them as a key resource mixing experts interviews, lessons learned from GET Funded event and a comprehensive investors’ list.

Source eHealthNews.eu http://www.ehealthnews.eu/download/publications/4434-get-funded-a-practical-guide-for-digital-health-smes

GET Funded: A Practical Guide for Digital Health SMEs

NHS nurse recruitment from EU 'too aggressive'

Nursing leaders in Portugal, Spain and Italy say “aggressive strategies” are being used to “fool” a growing number of their staff into working in the NHS.

Increasing numbers of young graduates are tempted by UK salaries up to three times what they might earn at home.

A body representing UK recruitment companies has admitted a few agencies “misrepresent” the work they offer.

Health Education England says it is increasing the number of nurse training places in England to fill NHS gaps.

Nursing shortages

In an HEE film, used to attract EU nurses, new arrivals to the NHS in the West Midlands are asked why they left Spain and Portugal.

They refer to the career and skills opportunities in the UK – as well as higher salaries.

But Portugal has its own nursing shortages.

The vice-president of Portugal’s nursing regulator, Dr Bruno Gomes, told BBC News: “Some recruitment firms have very aggressive tactics.

Temporary work

“The companies – mainly from the UK – come to the nursing schools, and hold big conferences in the fourth year of the degree.

“Among the conditions they offer is free language training, and sometimes accommodation for three or even six months.”

Spanish Council of Nursing president Dr Maximo Jurado told BBC News: “They lie – they fool nurses.

“Perhaps a group of nurses go to a country, rent a flat, and they think they are going to work at a particular hospital.

“Then that company organising temporary work sends nurses one day to a hospital in one city, another day to a different hospital in a different city.”

‘Poor planning’

Spain sends the largest number of nurses to the UK – about 2,000 last year.

Dr Jurado added: “There is a more general problem of poor planning by the NHS.

“Any health service in any country has to do appropriate planning for the future – because otherwise nurses will have to be recruited from other countries.

“We are all trying to plan for the future, in order not to have such a big gap.”

‘Lower salary’

Sometimes, the NHS enters into formal overseas agreements with local staffing boards – 150 nurses from Venice came to three hospitals in Manchester in this way.

Dr Genarro Rocco, who helps lead Italy’s nursing colleges, said: “We have had just a few complaints, but these are from nurses who were told they would be working in a hospital – and they end up providing just basic care instead.

“On other occasions, they were maybe getting a lower salary than what was promised.”

Samantha Hurley, from the Association of Professional Staffing Companies (Apsco), said: “”We are aware that misrepresentation can happen when recruitment firms engage professional healthcare workers from other EU countries.

“The issue is one of a lack of understanding of the process.

‘Ethical manner’

“In order to practise in the UK, healthcare professionals must register with the appropriate professional body and obtain a Pin number.

“Without which, for instance, a band-five nurse would not be able to work as such and would be in a position where they had to accept a band-two healthcare assistant role instead.”

Apsco says foreign staff need comprehensive preparation and induction – as one study indicated up to a third returned home within a year.

Ms Hurley added: “We believe that the vast majority of recruitment firms which provide international staff are doing so in an ethical manner and are ensuring workers are properly inducted.

“But a minority of recruitment firms, based not only in the UK but also in other EU countries, are shipping over large quantities of workers without the appropriate support.”

Source BBC News/Health http://www.bbc.co.uk/news/health-33691084

NHS nurse recruitment from EU 'too aggressive'