08/10/2010 by Patrick Keady.

It may – or it may not - be too early to ask who will be in
charge if there is another healthcare crisis? Although the
NHS White Paper seems not to answer the question
particularly well.

Who will be in charge is an important question. Perhaps the
most crucial of all. Given the potential human and financial
costs - the unnecessary loss of trust, reputation, lives,
careers and money.

Under HM Government plans for the NHS, it seems that
no single body - Department of Health, NHS
Commissioning Board, NHS England, Monitor or the Care
Quality Commission – will have the responsibility,
authority and powers to monitor the health system as a
whole, to identify potentially destabilising trends, and to
respond to them with concerted action.

Providers will have a joint licence, that is overseen by
Monitor and the Care Quality Commission. The CQC will
monitor safety and quality. It will address failure to meet
standards and the CQC will inspect against essential levels
of safety and quality.

Monitor will be charged with ensuring that competition works
in the interests of patients and taxpayers. If and when price
regulation is necessary, Monitor will set prices for NHSfunded
services, to promote fair competition and drive
productivity.

The Independent NHS Commissioning Board will resource
allocation and work directly with commissioners. It and the
NHS will be held to account through a set of national
outcome goals, part of the wider NHS Outcome Framework.

The Department of Health’s duties for the NHS will shrink
and be far more strategic, looking to improve public health,
tackle health inequalities and reform adult social care.

While the Secretary of State will hold the NHS Commissioning
Board to account. He will set legislative and policy
frameworks for which the NHS works.

In the meantime, what steps are being taken to prevent
systemic risk threatening the quality, activity and funding of
health services. Who is in the driving seat? Are other
Ministers and opposition MPs involved? What expertise is
being tapped into? Are ‘special forces’ officials ready to spring into action, to be
seconded specifically to deal with systemic risk?

Fingers and toes crossed that there are robust plans in
place to address these questions and that they there will not
be another NHS crisis. And if the answers are insufficient, at
least we’ll know who is in charge.

Someone who has to answer directly to Parliament, the
Secretary of State for Health. The buck stops with him.

Posted in NHS | Print | No Comments »

28/09/2010 by Patrick Keady.

A new website featuring every UK law in full is now available for free.

Launched by The National Archives, you can now scrutinise 6.5 million laws documents in England, Scotland, Wales and Northern Ireland. They are stored as PDF files.

“This is the public’s statute book,” said Lord McNally, minister of state and deputy leader of House of Lords.

legislation.gov.uk presents complex information in a clear and intuitive way. Lord McNally continued that the website is groundbreaking and that it puts democracy at the heart of legislation. The website makes a major contribution to the government’s transparency agenda.

The website replaces The Office of Public Sector Information and Statute Law websites.

Posted in NHS, Safety, Risk Management, Governance, Legislation, Health and, Patient, Strategy | Print | No Comments »

21/09/2010 by Patrick Keady.

The health White Paper promises significant changes to primary care and the way that healthcare is delivered.  BMJ Masterclasses aimed at clinicians and managers in primary care will equip GPs and their practices to meet the challenges and take the opportunities that lie ahead.

Understanding GP Commissioning, is a new one day course providing practical skills and advice on general practice commissioning, as well as

an essential overview of the recent health White Paper. It takes place at BMA House, London, on 30th September.

Improving Quality in Your Practice, takes place at BMA House, on 1st December. It will help GPs identify areas in their practice where they can improve quality and safety by working smarter, not harder, and develop an action plan for their surgery.

For details, click www.betteroutcomes.org/events

Posted in Innovation, Creativity, Safety, NHS, Patient, Legislation, Health and | Print | No Comments »

14/09/2010 by Patrick Keady.

The success of healthcare systems is often measured
in terms of quality, activity and cost. Compared with the
US, Germany and France, the NHS performs well. In
terms of GDP, we spend less.

However, things are less clear when we compare NHS
quality and activity. Statistics come to the fore. We
compare the NHS with the EU, north America and
Australasia. And we might be missing a trick.

Could it be that there are better healthcare systems
elsewhere in the World? Healthcare systems that
deliver more at less cost.

Take Japan for example. It stands at or near the top in
every comparative ranking of healthcare quality, activity
and cost.

Not alone is their healthy life expectancy 6% higher
than in the UK, they also have the best recovery rates
from just about all of the major diseases. Japan
leads the World in curing the diseases that
can be cured. Impressive.

The percentage of people dying from circulatory
diseases per 100,000, is 75% less than here. The
proportion of cardiac death is four times less. The birth
rate is 30% less and the proportion of the Japanese
population that is obese, is one seventh. Although the
percentage of daily smokers in Japan is higher -
30.3%, compared to 26% in the UK.

Cost control is one of the key drivers of Japan’s
success. It’s savings in the high-tech realm can be
awesome. An MRI scan of the neck region in Japan
routinely costs 9% of one in the US.

All 125 million residents have access to healthcare
services. The Japanese see a Doctor about three times
as often as people here in the UK, or those with
healthcare insurance in the US. The number of Nurses
per 1,000 people in Japan is less than in the UK : 7.8,
compared with 8.8 in the UK.

And they have almost three times as many hospital
beds per 1,000 people. The average hospital stay is
four times the US average. The Japanese get twice as
many prescriptions and three times as many MRI
scans.

And the cost of caring for every person living in Japan
is less than half that of caring for the 80% of Americans
with health insurance. Total expenditure is less
than in the UK too - 7.8% GDP versus 8.1%.

So what do you think?

Post your thoughts below.

Posted in Risk Management, Innovation, Creativity, Public Health, Safety, Health and, Governance, NHS, Strategy | Print | No Comments »