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The North West Strategic Health Authority was formed on 1 July 2006.
Where possible reports will continue to be shown under:
Cheshire and Merseyside Strategic Health Authority
Cumbria and Lancashire Strategic Health Authority
Greater Manchester Strategic Health Authority
- Hospitals
resort to pen and paper after £1bn computer crashes. A £1bn
administrative computer system used by eight major hospitals and 72
primary care trusts crashed on Sunday morning following problems with power
supply. The system, which is used to log appointments, admissions, operating
theatre booking and local clinics, is supplied be CSC Alliance based in
Maidstone, Kent. The crash was caused by a power failure in the company's
central data centre making it inaccessible. The incident has affected services
to other CSC Alliance customers though they have now been restored; NHS
systems are currently still being brought back up. Adrian McDermott, the
deputy chief information officer for NHS North West
said that staff were using manual back up systems and checking appointment
lists by hand which "will cost time and money when we have to input the
information". He added: "We have managed the impact as best we can."
Summary by
Keep our NHS Public
of Telegraph
1 August 2006
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Private firms put squeeze on pay. As doctors at the end of their
training struggle to find work,
private companies are offering them jobs at salaries below those of the NHS.
Private companies with
independent sector
treatment centre (ISTC) contracts are offering jobs at salaries below NHS
rates. A surgical SpR in the north of England is understood to have been
offered a job by an ISTC provider, handling just outpatient work, at a salary
of around only £50,000. ATOS Origin, which is the preferred bidder in the
South West and North
West of England under the independent sector diagnostics procurement, is
advertising for consultant radiologists in these areas at salaries no higher
than £65,000. The posts require a specialist diploma and help is being offered
in applying for full GMC registration, suggesting that the company is
targeting doctors from outside the UK. It is also advertising for 'lead
radiologists' with previous UK work experience and prior management
responsibility. These posts, advertised at only £75,000 plus a car, will
involve a requirement to set up a 'training structure' for NHS trainees. Summary by
Keep our NHS Public
of Hospital
Doctor 19 October 2006
- NHS criticised over naming and shaming of endangered health trusts.
The government was criticised today for drawing up a hit list of 77 NHS trusts
at risk of closure, cuts in services and significant debt. The list, released
today by the Department of Health (DoH), also highlights which trusts are
likely to come under the most media scrutiny - prompting accusations from
doctors' leaders and opposition MPs that NHS reform is being driven by
political priorities rather than clinical need. The so-called "heat maps"
assessed whether individual NHS trusts would face national, regional or local
media attention and when this coverage was most likely to occur. It also
identified where NHS closures or cuts could affect Labour MPs. The list was
released by the DoH following a request by the Conservative party under the
Freedom of Information Act. Under the plans to reform the NHS, more patients
would be treated in the community rather than at their local hospital, and
specialist services would be taken away from local hospitals to create
regional centres of excellence. The impact was expected to be greatest on
acute and community hospitals. The list showed that NHS trusts in
London were most at risk, with eight of the 12 identified likely to
attract national media attention. he list also included 10 trusts from the
east of England, and nine each in the
north-west, south
central and south-east coast. David Batty
and agencies
Wednesday November 8, 2006 Guardian Unlimited
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Finding NHS reforms difficult to trust…
In a letter to the Guardian consultant anaesthetist Dr. Katherine Teale
writes: "I am puzzled why there is no mention of the latest nail in the NHS's
coffin - the rolling out of the "integrated
clinical assessment and treatment service" centres across the
north-west. These privately run clinics are
going to take most of the outpatient services out of our NHS hospitals, which
are quite lucrative and easily run. Just as many hospitals achieve foundation
status, and have to balance their books as well as taking on PFI loans, the
government has removed a considerable chunk of their income. This has been
done without any public consultation, and will undoubtedly lead to the closure
of many local departments." Meanwhile an anonymous letter from a nurse says:
"Polly Toynbee argues that the government needs to "win back trust" of the
doctors and nurses so that they "make the case and take the strain for these
reconfigurations" (i.e. yet more changes to the health service). Has she ever
stopped to wonder why nurses and doctors do not support the government's plans
? It is nothing to do with "trust" but everything to do with deep worry that
these "reconfigurations"
will not lead to better care and in some cases worse patient care. I have yet
to meet a practising doctor or nurse who supports these measures. We are not
in nursing to make money. We are in the profession to help sick and ill
people, and what really upsets us most is that so much extra money has been
spent on the NHS with so little to show for it in terms of better patient
care. Even the much-heralded improvement in waiting times is on the whole
not a real
improvement: at my hospital patients are frequently given numerous
irrelevant interim appointments before the final appointment for treatment,
and what is measured statistically is the waiting time between each of these
interim appointments. Patients are often not getting actual treatment any
quicker than they were 10 years ago. Trust or otherwise in the government is
not the issue for nurses and doctors. Sensible health policies in practice are
the issue."
Summary by
Keep our NHS Public
of Guardian
23 November 2006
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PbR to become
'payment for performance' in NHS North West. Payment by results is set to
become payment for performance in the North West of
England, under a US model that rewards hospitals for the quality of their
care. Providers within NHS North West could be paid extra by primary care
trusts if they score highly on clinical benchmarks as early as October, if the
strategic health authority strikes a deal with a US not-for-profit hospital
alliance. NHS North West chief executive Mike Farrar said it was 'a long way
down the road' towards signing a deal with US outfit Premier to bring its
payment model to the UK. Premier's hospital quality incentive demonstration,
which began in 2003, has tested whether financial incentives are effective at
improving the quality of inpatient care across 260 hospitals, using metrics to
judge performance across five clinical conditions: pneumonia, heart failure,
hip and knee replacement, heart bypass, and acute myocardial infarction. The
scheme measures the quality of care provided as well as outcomes. The top 10
per cent of hospitals in each clinical area receive a 2 per cent payment
bonus, with the next 10 per cent getting 1 per cent extra. NHS North West
hopes to introduce the model across part of its area in October, with the
whole patch taking it on next year. Summary by
Keep our NHS Public of Health
Service Journal 2 February 2007
- Cash for
keeping patients alive. Hospitals are to be given cash bonuses - for
keeping people alive. Regional health bosses are planning to try out a US
system of rewarding trusts which have low death rates, levels of infection and
readmissions. It will be piloted in part of the
north west from October and all the region's hospitals from next April.
Trusts will compete for a total pot of £1.5m. Any hospital that ranks in the
top 10-20% will get a share. But Stephanie Thomas, of the Unison union, said:
"We would be concerned that by rewarding the best performing trusts rather
than giving extra help to those which are struggling. It will not improve the
system as a whole but create super centres and leave other trusts struggling
to survive." Performance tables will be published at the end of the year, so
as well as earning cash incentives top-ranking hospitals are expected to
attract more patients. Senior doctors yesterday welcomed the focus on quality
of care but said they were concerned about the element of competition in the
scheme and would prefer to see rewards for all trusts which achieved a fixed
target. They also said bosses need to take account of the varying health
levels in different areas which could affect survival rates. NHS north west
chief executive Mike Farrar is pioneering the scheme. Currently the NHS is
changing to a new payment system where hospitals get paid a set amount for
each procedure they do. If successful, Mr Farrar's plan would ultimately
replace this. He said: "Payments need to have some link to quality of care. At
the moment organisations receive cash for each procedure they perform
irrespective of whether the operation failed. This is the next step in the
jigsaw. The results of the American trial are astounding. The hospitals which
scored highest on quality outcomes showed very dramatic reductions in case
costs, had significantly shorter lengths of stay, lower mortality rates, lower
complication rates and lower readmission rates than hospitals which scored
less well. Those hospitals which were serious in pursuing higher quality
patient care were both more efficient and more effective than those that were
unable to achieve the same quality standards." Summary by
Keep our NHS Public of Manchester
Evening News 9 February 2007
- Growing boycott
of flawed recruitment. The row over training of junior doctors has
intensified as more senior consultants decided to boycott the interview panels.
Hopes that a Government climbdown on Tuesday would reduce pressure to abandon
the new system faded as two more groups decided they could not conduct the
interviews when they were not confident that the right candidates had been
selected for interview. Eight plastic surgeons on the panel in the
North West, based in Manchester, have informed
the postgraduate training body that they will not proceed with the interviews
scheduled for later this month. They said the interviews should be rescheduled
for a later date, when candidates' CVs should be taken into account. Patricia
Hewitt, the Health Secretary, agreed for an immediate review of the system,
which is now being carried out by the Academy of Medical Royal Colleges. It may
call for some changes. The British Medical Association's junior and senior
doctors say the system should be suspended. The Royal College of Surgeons and
the Royal College of Anaesthetists have made their own protests.
Summary by
Keep our NHS Public of Telegraph
9 March 2007
- DoH orders
review into £257m diagnosis contract. A massive diagnostics contract with
the private sector has been delayed because of concerns about quality and
administrative procedures. The Department of Health has ordered an independent
review into work done by Atos Origin for primary care trusts in the NHS North
West region. Atos has been working with eight PCTs since December but a much
wider contract for the NHS North West region
and the NHS South West region was due to start
on Monday. The £257m five-year contract was meant to provide 450,000 tests a
year from 60 fixed sites and 17 mobile test centres. But it has been delayed
until the results of the independent review are released. The move has left
PCTs struggling to find alternative providers. NHS North West said patients
are being offered alternative appointments, either in the NHS or with another
independent sector provider. Atos was meant to provide CT and MRI scanning,
ultrasounds, x-rays, audiology and other diagnostic tests to boost capacity
and help PCTs hit next year's 18-week referral to treatment target. Atos would
handle the entire process from appointment booking to test interpretation and
report delivery. The deal has been halted because ultrasound and MRI scan
patients at PCTs in the North West already contracted with the company ahead
of the main Department of Health-negotiated contract have had to be recalled
for repeat tests. As part of the review, each scan or ultrasound is being
re-examined and it is possible more patients will be recalled. No new patients
are being referred to the interim service and the DoH has said the main
contracts will only go ahead when it is certain patient safety will not be
affected. The DoH said the start date of the main contract would have had to
be delayed regardless of the problems in the North West. 'There are conditions
in all our contracts which providers have to meet before we will allow
services to commence,' said a spokesman. Summary by
Keep our NHS Public of Health
Service Journal 29 March 2007
- £1m company to
tackle inequalities in North West A company established to deliver better
public health for people across the North West is set to launch in the next
few months. NHS North West is planning to pump
£1m into a community interest company in an attempt to improve the health of
its population and stem the tide of rising health inequalities. The strategic
health authority hopes the company, under its 'living better, living longer,
caring more' campaign, will develop a region-wide health programme supported
by a social marketing campaign. NHS North West is currently recruiting a
programme director to run the company and will bring together stakeholders
from public sector organisations across the region to form a board. In a
briefing paper to the SHA board, director of public health Dr Ruth Hussey said
'leadership and direction on health messages would be best accepted from an
independent organisation', as public confidence in what are seen as government
messages is low. The company will run the public health programme over four
years, focusing on obesity in its first year. According to the briefing paper
the programme also aims to: transform public sector approaches to
communication with the public about health; build capability for improved
communication with the public and private sectors; engage the public and
private sectors in understanding the health impact of key policies and
strategies in order to facilitate policy change; measure and disseminate the
impact of the programme through research and evaluation.
Summary by
Keep our NHS Public of Health
Service Journal 26 April 2007
- NHS cutbacks
leave £500m unspent. The NHS has underspent by half a billion pounds as a
result of the aggressive cuts imposed by the health secretary, Patricia
Hewitt, a Guardian analysis of health authority figures has revealed. The size
of the underspend caused fury among health union leaders yesterday, who said
it was generated by an unnecessarily harsh squeeze on spending during the
winter months when many NHS trusts economised by closing wards, axing jobs and
delaying operations until the start of the new financial year in April. ...
The biggest surplus was in the north-west,
where the NHS ended the financial year with £161m in spare cash. Other
surpluses included £116m in
Yorkshire and Humberside, £92m in
London and £73m in the north-east. The only deficits came in the
eastern region, which overspent by
£152m, and the south-east coast, which was
nearly £55m in the red. John Carvel, social affairs editor
Tuesday May 29, 2007 The Guardian
- Biggest ever health survey in the North West. The North West Public Health
Observatory and the Centre for Public Health, Liverpool John Moores
University, will launch the biggest ever health survey of residents of the
North West on behalf of the NHS North West.
Care & Health 8 June 2007
- Trusts face
monitoring on take-up of private services. In a letter to PCTs,
NHS North West chief executive Mike Farrar has
warned that he is seeking guidance on whether PCTs will be measured on how
many patients choose to use integrated clinical assessment and treatment
services (ICATs) run by private companies Netcare and Partnership Health
Group. Mr Farrar says the SHA is "expecting reassurance from the Department of
Health that if PCTs achieve their access targets and if under-utilisation is
caused by patients exercising choice, they will not be performance managed
against this". However, speaking to Health Service Journal, Mr Farrar could
not provide this reassurance. "To check PCTs have made a good investment and
are meeting the 18-week waiting time target we obviously have to count the
numbers and feed those back to the DoH," he said. Although PCTs were forced to
pay for the full number of contracted operations (regardless of how many took
place) in the government's first wave of independent sector treatment centres
(ISTCs), the Department of Health will pay for any unused capacity in the
second wave, including ICATS. The Department of Health would not comment on
whether PCTs would be performance managed on patient use of ICATS. In the
letter Mr Farrar also said: "The SHA will look particularly closely at PCTs
where GP groups are in danger of having a conflict of interest between the
practice-based commissioning and other business interests". Patient and public
involvement forums for both Royal Liverpool and Broadgreen University
Hospitals trust and Liverpool PCT recently called for the suspension of the
ICATS scheme for dermatology over questions around the role of a GP - who was
linked to one of the private providers - in drawing up the specification for
the service.
Summary by
Keep our NHS Public of Health
Service Journal 14 June 2007
- Johnson blocks new wave of private clinics. The health secretary,
Alan Johnson, yesterday vetoed plans for a third wave of independent-sector
treatment centres to compete with NHS hospitals. In a break with Tony Blair's
drive to expose the health service to the challenge of market forces, Mr Johnson
said local NHS commissioners should adopt a more pragmatic approach to treating
patients on the waiting list for tests and operations in England. He will allow
them to buy extra capacity from the private sector if they need it to meet
targets on waiting times, and can show it provides value for the taxpayer. But
he told the Commons health committee: "There will be no need for another
national independent-sector procurement ... There will not be a third wave." The
government had been committed to spending about £4bn on the first two waves of
treatment centres - fast-track clinics that were to carry out 2m routine medical
procedures on NHS patients. Mr Johnson was presented with plans for a third wave
when he became health secretary last month, but he refused to endorse them. To
underline the change, he scrapped contracts with Atos Origin in the
north-west and south-east [actually
south west]of England,
accusing the company of failing to deliver in time. Mr Johnson said: "Where
independent sector providers are not offering good value for money or
high-quality patient care ... we will terminate [their contracts]." John Carvel,
social affairs editor
Thursday
July 26, 2007 The Guardian
- Health group
fired over contracts failure. Atos Healthcare has been fired by the
Department of Health for failing to deliver multi-million pound contracts for
diagnostic services in the north-west and
south-west of England. Health secretary Alan
Johnson also announced that the third of the second wave of independent
surgical treatment centres will proceed with Swedish owned Capio in
Lancashire and Cumbria. However, he also told the Commons health select
committee that only "some" of this wave would be going ahead. Andrew Lansley,
Conservative health spokesman, said that this marked "a clear break from
Blair's public service reforms", while the CBI said the independent sector
"will be alarmed by this apparent shift into neutral" on the ISTC programme.
Neil Bentley, the CBI's director of public services, said: "The government's
commitment to driving [the ISTCs] forward seems in doubt." Atos Healthcare was
widely known to be struggling on the contracts which were meant to take effect
form April. The Department of Health said it would not re-tender the Atos
deals, but rather would let strategic health authorities and primary care
trusts decide how to fill the hole. The NHS Partners' Network, which
represents independent providers, said the work had to be put to competitive
tender open to the private sector. Mr Johnson said that where the independent
sector could provide good value, adequate capacity and more choice, "we will
bring them in. Where they are inefficient, we will terminate". Reform, the
pro-market think-tank, said Gordon Brown's government was now "in retreat"
over Blairite reforms to health, schools, housing and university finance.
Summary by Keep
our NHS Public of Financial
Times 26 July 2007
- Johnson takes
tougher line over ISTCs. Business leaders have warned that the private
sector is receiving mixed signals from the Department of Health over the future
role it can play in the NHS. The criticism came as Health Secretary Alan Johnson
announced that the DoH had terminated its £257m contract with Atos Healthcare, a
subsidiary of the US IT firm Atos Origin, for diagnostic services in the
Northwest and
Southwest. The contracts were due to start in April 2007 and run until April
2012, but were suspended following concerns about the quality of Atos'
performance on separate smaller contracts in the Northwest, which led to a
number of patients needing to be re-scanned. But the termination of one troubled
contract is unlikely to be the source of the independent sector's concerns.
These are more likely to stem from Johnson's comments on the ISTC programme as a
whole. The new health secretary told the committee: 'The NHS doesn't have a
monopoly on public service, nor does the independent sector have a monopoly on
efficiency, and where an independent sector provider is not offering good value
for money or high-quality patient care we won't [accommodate] them in the NHS.'
Although Johnson said that ISTCs had been an important part of attempts to
reduce waiting lists and spread good practice in the NHS, he added that
introducing Patient Choice did not mean the government sought to introduce
surplus capacity. Johnson confirmed that, despite criticism of the ISTC
programme from the health committee itself, he would not be 'revisiting'
decisions made by his predecessor health secretaries. He went on to announce
that Capio Healthcare had won a new contract for seven separate ISTCs in the
Northwest, which would be expected to perform 11,000 procedures a year over a
period of five years. The Capio contract forms one of 15 ISTC schemes expected
to be commissioned under phase two of the programme, which had initially planned
to result in 32 new private treatment and diagnostic schemes. Johnson said he
expected to approve more schemes in the coming months, but added that any
proposals would be subject to 'rigorous process… whether it has always been a
rigorous process I am not sure.'
Summary by Keep
our NHS Public of Public
Finance 27 July 2007
- Union
"gobsmacked" by ambulance funds blow. North
West Ambulance Service has admitted that it can only afford 35 of the 128
ambulances it needs to buy to replace over a third of its 345-strong fleet.
Unions have claimed that the admission that all but 35 will not be bought
until 2008/ 09 due to "the major
capital and revenue impact" of replacing even the most urgent 50, casts doubt
on claims that the reorganisation of England's ambulance authorities would
give better strategic capacity. The ambulance trust said it had inherited its
problem from its predecessor trusts. Craig Wilde, North West Ambulance Service
Unison branch secretary, said: "We were told that with the merger comes
increased buying power. We are such a large trust now. We could afford [to buy
new ambulances] when we were under Greater Manchester Ambulance Service so why
can't we afford it under NWAS ?" He
added that ambulance crews might have to hunt for working vehicles as those
nearing the end of their use would need more maintenance. Association of
Professional Ambulance Personnel spokesman Jonathan Fox said: "One of the
justifications for replacing the trusts was that it was going to have a
positive impact on patient care. If you have a shortfall of finances then that
premise is going to be seen as hollow." Board minutes from the trust admit
that the number of vehicles they can afford is "significantly less than the
number that would ideally be needed to bring the fleet age profile up to an
acceptable level". The trust admitted there had been "slippage" in the
replacement programme since its merger. A DoH spokeswoman said: "The
reconfiguration was about establishing trusts of a size that can deliver
appropriate investment in people and resources to underpin current and future
services, and ensuring resources are targeted at where they are most needed -
improving patient care and supporting frontline services."
Summary by
Keep our NHS Public of Health
Service Journal 16 August 2007
- Outsourcing
contract to save NHS £5.5m. NHS trusts in the
North West of England have streamlined their document and print management
services. The North West Collaborative Procurement Hub (NWCPH) signed a
five-year contract with Xerox, and predicts it will amass cost savings of around
£5.5m through the reduction of waste and unnecessary print expenses and the
increase in productivity levels. As part of the contract, Xerox is providing
core office functions to eight NHS trusts, such as copying, faxing, printing,
scanning, storage and the retrieval of administrative documents and research
papers.
Summary by
Keep our NHS Public of ZDnet.co.uk
17 September 2007
- NHS patients who complain risk victimisation, say inspectors. NHS
patients who complain about a poor standard of care are at risk of being
victimised, health inspectors warn today after the first national audit of the
complaints system in England. The Healthcare Commission said it launched the
review after becoming increasingly concerned about how hospitals and primary
care trusts respond when patients criticise the behaviour of staff or
conditions in hospitals or GP surgeries. After a risk assessment of all
trusts, it identified 32 hospitals, ambulance services and primary care trusts
which appeared to have the least satisfactory arrangements. Inspectors found
none had comprehensive safeguards to ensure that people who complained could
be confident their care would not suffer as a result. They identified
"significant lapses" at nine of the audited trusts. "The main concern was an
absence of systems to monitor whether care had changed in any way as a result
of a complaint," the commission said. Few trusts were using complaints to
learn how to improve the service. The commission named 12 trusts where it
found "significant lapses" in one or more of the national standards for
managing NHS complaints. It said this would affect their marks in the annual
performance tables. Another six were given formal warnings and 12 were told to
make improvements. Only two got a clean bill of health. The commission
investigates about 8,000 appeals a year from patients who have complained to a
hospital or primary care trust and are dissatisfied with the response. Its
report concluded: "Processes can be fragmented and applied inconsistently
within individual trusts and across the NHS ... the emphasis remains on the
process rather than seeking to find resolution for the person raising a
complaint." It criticised trusts for doing little to help people from ethnic
minority communities or patients with learning difficulties. Anna Walker, the
commission's chief executive, said: "Given that the NHS provides 380m
treatments a year, the number of complaints - 140,000 - is relatively small.
But when someone does complain, trusts need to respond well. Patients want
complaints resolved quickly and locally." The report praised one of the
largest and busiest acute hospitals in the north-west for learning from a
complaint about a patient who died after an MRSA infection. Relatives
expressed concern about staff wearing uniforms outside the hospital, risking
contamination. The trust devised a new dress code and invested in facilities
for staff to change clothes. Peter Walsh, chief executive of Action against
Medical Accidents, said: "This audit is further evidence, as if we needed it,
that the way many NHS organisations handle complaints adds insult to injury
and there is an urgent need for improvement."
John Carvel, social affairs editor
Monday
October 8, 2007 The Guardian. [The list is incomplete as it omits NHS
bodies in the
York area, despite the prolonged neglect of
Sharon Wilson.]
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Heat Map North West
SHA forecasts 2006 07
North West
Healthcare organisations weak for quality of services
Central Cheshire Primary Care Trust
Cheshire West Primary Care Trust
Cumbria Ambulance Service NHS Trust
Mersey Care NHS Trust
Mersey Regional Ambulance Service NHS Trust
Mid Cheshire Hospitals NHS Trust
Morecambe Bay Primary Care Trust
Healthcare organisations weak for use of resources
Carlisle and District Primary Care Trust
Cheshire West Primary Care Trust
East Cheshire NHS Trust
East Lancashire Hospitals NHS Trust
Eden Valley Primary Care Trust
Ellesmere Port and Neston Primary Care Trust
Mid Cheshire Hospitals NHS Trust
Morecambe Bay Hospitals NHS Trust
North Cumbria Acute Hospitals NHS Trust
Southport and Formby Primary Care Trust
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