Patient Association News UK November 2014

The Patients Association hosts APPG on Care.data
This week the Patients Association hosted an influential All Party Parliamentary Group (APPG) evidence session at Westminster. The Patients Association provides the secretariat services for the APPG for Patient and Public Involvement in Health and Social Care. This year we have been looking at the highly controversial topic of Care.data.

Care.data is a major new IT programme which will enable information on GP records to be shared with the Health and Social Care Information Centre (HSCIC). This scheme, which had been planned to be rolled out in the spring of 2014, is intended to help the NHS plan and improve patient care for the whole country. Information is already available from hospital records, but to date it has been difficult to link those records with the information that is available from GP surgeries.

However, concerns have been raised, including to the Patients Association Helpline, regarding this new data sharing programme. There is public uncertainty about the arrangements around sharing of patient information. Some of the issues raised are:
what type of information will be shared who will have access to the records how to opt out At the event, NHS England’s National Director for Patients and Information, Tim Kelsey, provided an up-to-date summary of where NHS England is up to with the programme and its plans for taking it forward. Evidence was provided by Kidney Research UK, the Royal College of Physicians and the Association of Medical Research Charities.

The debate was chaired by John Pugh MP, and Rosie Cooper MP ensured that the discussions remained “lively”. We will publish our report of our findings at the end of November.

Overstretched GPs striking patients off their lists

Overstretched GPs have been given the go-ahead to strike thousands of patients off their lists. So far, 25 surgeries across England have been granted approval by NHS bosses to shrink their catchment areas. Some practices have already removed as many as 1,500 patients from their lists. A further ten surgeries have applied this year to cut their registers and are awaiting approval.

GPs say they are in the grip of a recruitment crisis and cannot provide safe care for the rising numbers of people moving to their areas. On top of this, many GPs are retiring, moving overseas or quitting altogether and there is a shortage of new doctors entering the profession.

Figures from NHS England show that 15 practices were granted approval to shrink their catchment areas in 2013/14 and another ten so far this year since April. Officials would not identify individual surgeries but they are in areas including Surrey, Sussex, Greater Manchester, Leicester, Lincolnshire, Herefordshire and Worcestershire.

Dr Maureen Baker, Chair of the Royal College of General Practitioners, said:

“This is an extremely distressing situation for patients and for GPs. Every patient should be able to see their family doctor when they need to, and GPs want to provide the best possible access and care for all their patients.”

“No surgery wants to de-register patients. This is still extremely rare and only takes place as a very last resort. Unfortunately, what we are seeing now is a sad consequence of the desperate shortage of GPs, with many practices finding it difficult to replace doctors who are retiring.”

Katherine Murphy, Chief Executive of the Patients Association, said,

“The Patients Association has campaigned tirelessly over many years for better patient access to GP services. Since the publication of our report: Access Denied, in 2013, our Helpline has continued to receive an increasing number of calls related to primary care issues. We receive countless calls and emails from patients who are unable to access GP services when they need them. Patients are also reporting that they are unable to make appointments in advance and are unable to see a doctor of their choice. Unfortunately, patients have no control over when they are going to be sick and therefore they must have access to a GP when they feel unwell.”

“It is therefore vital that well managed and properly funded GP services are made available to all patients across the country. Long waiting times to see a doctor not only prolongs a patient’s suffering and discomfort, but can also cause their condition to deteriorate. Without access to a GP, patients will inevitably present at A&E, placing extra pressure on an already overstretched system.”

“The “shrinking” of GP lists is simply unacceptable and not in the interests of the people who matter; patients themselves. We must protect GP services and achieve real choice for patients. Investment in buildings, GPs, nurses and services must be a priority if we are to offer patients the healthcare that they deserve.”

Care plan 'to ease hospital pressure' in England
Patients in England will get better support in the community as part of plans to ease pressures on hospitals. Joint teams of social care workers and NHS staff, such as nurses, will become available seven days a week under the changes being unveiled. The move is part of the government's Better Care Fund to join up the NHS and council-run social care systems.

Ministers believe the plans will help prevent more than 160,000 hospital admissions, 2,000 care home admissions and result in more than 100,000 fewer days of unnecessary hospital care caused by delays in discharging patients.

The King's Fund quarterly monitoring report found that 5% of patients were spending four or more hours in A&E - the highest level at this time of year for a decade. The review also highlighted that waiting times for routine operations such as hip and knee replacements, had reached their highest levels since 2008 with 12.1% of patients waiting more than 18 weeks. The latest figures for the 62-day target for cancer treatment also show that it is being missed, although those figures only cover the period to June.

Health Secretary Jeremy Hunt said:

"For years, successive governments and NHS leaders have talked about joining up our health and care services so people get better care at the right time and in the right place.

"The time for talk is over - our plans will make this vision a reality for patients and help deliver a sustainable future for the NHS.

"Too many families experience being passed from pillar to post between the NHS and their council endlessly repeating stories along the way."

'Spider' CCGs should add co-commissioning public health to their web

The Health Secretary, Jeremy Hunt, has said that Clinical Commissioning Groups (CCGs) should expand their co-commissioning responsibilities to public health, and become the ‘accountable care organisation’ for all of their patients’ care

Mr Hunt said this would allow them to tackle priorities such as obesity, outlined in the NHS England ‘Five-year Forward View’, and that he envisaged CCGs being ‘the spider at the centre of the web’ of patients’ care.

During his speech at the Best Practice show in Birmingham, he reiterated plans for GPs to also take on social care commissioning. And he explained that clinically-led CCGs had helped drive improvements in joined-up patient care, and were now starting to use their position to implement ‘extraordinary innovations’.

Mr Hunt told delegates:

“I’d like to see CCGs, clinically-led, becoming accountable care organisations, responsible for all the care of the patients they look after.

‘Not just commissioning secondary care, but with the Better Care Fund co-commissioning social care, with NHS England co-commissioning primary care and with local authorities co-commissioning public health.

He added:

“And I think CCGs, if you like, can be the spider at the centre of the web, working closely with lots of people.”

NHS staff to stage new four-hour strike over pay
NHS workers, including nurses and midwives, are to stage a new four-hour strike in England, on the 24th November as part of an ongoing pay dispute. Members of nine unions will walk out over the government's decision not to accept a recommended 1% pay rise. A Department of Health spokesperson said they could not afford the pay rise "without risking front-line jobs".

Christina McAnea, Chair of the NHS trade unions, said the government had left them with "no alternative". She warned Health Secretary Jeremy Hunt that he needed "to realise that this dispute is not going away".

"All we are asking for is fair pay," she said.

The announcement follows a four-hour strike on 13 October, the first in the NHS over pay for 30 years.