Board Meeting in public of NHS England, 29th January 2015
This is a long report, with the following sections:
- Launch of NHS Citizen website, on the day of the Board Meeting:
- Chief Executive’s report:
- NHS Performance report:
- Pressures on non-hospital services:
- Actions to support Urgent Care:
- Five Year Forward View update:
- Patients Online:
- Integrated Personal Commissioning:
- Personal Health budgets:
- Care.data Programme
- Proton Beam Therapy
- 1. Launch of NHS Citizen website, on the day of the Board Meeting:
The NHS Citizen model can be seen at www.community.nhscitizen.org.uk
It is currently a work in progress, but it is hoped it will eventually form a new culture of collaboration between NHS England and the public.
Quoting from the website:
“You will no longer be just an end-user of the NHS, but an active participant in its future. You will have the power to raise issues for discussion, connect with others who have the same interests, and even be able to hold the NHS England Board to account. NHS Citizen will have three connected parts:
- Discover - find out what people are saying about the NHS
- Gather – have a discussion about what is important to you
- Assembly - work with others to make the NHS better”
The full NHS Board has a commitment to engage directly with citizens biannually.
- Simon Stevens thanked staff for sterling work across the very difficult period of Christmas and the New Year, despite the unprecedented demands on NHS services.
- He identified NHS priorities as:
- Sufficient capacity
- Coordination of services
- Development of clinical processes
- Redesign of emergency services
- The NHS is currently achieving the second highest patient satisfaction ever recorded, plus the lowest ever dissatisfaction. These results are comparable across all three major political parties.
- UK cancer survival rates are the highest ever recorded.
- New models of care will be developed from April 2015, pilots for others to follow – joint models involving social care services, local government, Clinical Commissioning Groups and NHS England.
- 90% of patients are satisfied with 111 telephone advice services. In an average week in 2014 the service received 230,000 calls – but in week ending 29th December 2014 439,000 calls were received!
- A&E departments’ January waiting times improved to 92.4% of patients treated and discharged or admitted within four hours, but the 95% target was not achieved. Most breaches are for patients waiting to be admitted – those subsequently discharged from A&E tend to be seen and treated much more quickly.
- Best and worst A&E departments were listed, including 18 Trusts with five or more waits of over 12 hours between the decision to admit and the actual admission – none in any of these categories are in NW London or SW Hertfordshire.
- There are not enough ambulances. Ambulance services are also facing recruitment problems.
- Concern was expressed about A&E trolley waits – the patients must receive good clinical care
- The Chief Medical Officer expressed the view that when NHS services are good for children and mental health patients, they are likely to be good for everyone.
Over the past decade investment in primary and community services has not increased appropriately and in some places there is difficulty in recruiting GPs and other staff. These constraints and pressures on social care lead to increased acute admissions and delays in patients being discharged.
Delayed discharges attributable to social care accounted for over a quarter of the total, with a further 7% attributable to both social care and the NHS. The largest proportional increase has been in “patients awaiting nursing home placement” followed by “patients awaiting care package in own home” . £25m has recently been made available for care home packages and £10m for domiciliary care.
A total of £640m was allocated through CCGs for operational resilience through the winter leading to extra beds and extra staff. Significant support has also been given to ambulance services – London Ambulance Service receiving over £17m resilience funding.
Notable steps include:
- Good progress on a national diabetes prevention programme.
- A new cancer strategy is being developed
- Sam Jones appointed Director of New Models of Care. A limited number of partner sites will be developed in 2015-16, to develop prototypes easily replicated by others.
This supports online services for patients in general practice, booking of appointments (91% of patients can do this), ordering of repeat subscriptions (88% of patients can do this) and access to summary information online, which in December 2014 was possible for 34% of patients – compared with 3% at that time in the previous year.
The aim is to have 95% of practices offering these online services by March 2015.
This aims to create a new voluntary approach to blending health and social care for individuals with complex needs, with an integrated “year of care” personal budget managed by people themselves, or on their behalf by councils, the NHS or a voluntary organisation. Sites have now been selected and will submit plans for their local plan by March 2015. A delivery support programme is being developed.
All CCGs have signed up to NHS England’s support programme and as of September 2014 nine out of ten CCGs were in a position to deliver Personal Health Budgets locally to people receiving NHS Continuing Healthcare.
The 2015-16 planning guidance expects CCGs to expand personal health budgets across health and social care for people with learning disabilities who have complex needs and children with special educational needs and disabilities as part of their integrated education, health and care plans.
10. Care.data Programme:
The care.data programme is commissioned by NHS Englandon behalf of the health and care system. It aims to increase the range and detail of information that is collected across all NHS funded services for purposes beyond direct care to make it available to those who plan NHS services, as well as to researchers, medical charities and businesses that support the NHS to improve services. The first phase is to collect and connect information securely from hospitals and GP practices.
The programme has been re-designed in the wake of concerns about who might have access to these linked data and for what purposes. As part of the Care Act 2014 access to this data will only be allowed for the provision of health and care and the promotion of health. The data cannot be shared for purely commercial purposes such as insurance or direct marketing. There is commitment to full transparency and audit of all third party access to the data.
Six pathfinder CCGs in four areas of England have volunteered to test the new approaches to public and clinical engagement. A panel led by Dame Fiona Caldicott will evaluate whether the success criteria for the pathfinder stage have been met.
11. Proton Beam Therapy:
Two hospital are to provide this therapy – University College Hospital NHS FT and The Christie Hospital NHS FT. Contracts are expected to close in summer 2015.
Next meeting: This will be in Leeds on Thursday 26th March 2015.