Election Battle Lines Are Drawn

Gordon Brown has confirmed that the next general election will take place on 6th May this year and with that date only a matter of weeks away, each party is busy campaigning to make sure their policies are the most talked about. Health has been very much at the centre of the political battle for some time, but with the election campaigns really building pace now, the Independent has outlined the major policies for each party when it comes to the NHS.

Interestingly, the Liberal Democrats are the ones to make most reference to NPfIT, claiming they would scrap the programme, as well as scaling back the “choose and book” appointment scheme. Their focus instead would be on introducing varied waiting times “for different conditions in place of the existing blanket 18-week target, and mental health services would be included”. While the proposal to target different conditions separately certainly has its merits, without a focus on healthcare IT, how are these targets to be met?

While NPfIT is not without its critics, it has achieved a significant amount since implementation and with the money that has been ploughed into this, a complete scrappage, especially with no supporting IT plans in place, risks causing more problems for the NHS.

Labour’s current focus on health seems to be steering clear of NPfIT, while instead opting to promote the flexibility they would look to offer the public through the introduction of “patient rights”. These would see people able to see doctors at weekends and in areas closer to where they work, with the removal of GP boundaries. They also claim they will reduce management costs by 30% over four years, if elected.

Finally, the Conservatives offer proposals that would see the NHS opened up to competition from private organisations, as well as introducing an independent board for the NHS. They also claim they would scrap “politically motivated” targets and place more emphasis on outcomes, “including survival rates for cancer, stroke and heart disease as well as patients’ satisfaction levels”.

The next few weeks will see endless campaigning by all three parties and the discussion on health is sure to be one of the hottest topics and while the Liberal Democrats may be the only party currently directly tackling NPfIT, such a large scale programme is guaranteed to be at the centre of several political debates, as no matter what the outcome of the election, the development of IT in healthcare is essential to ensuring high quality service for patients, making NPfIT a real talking point.

Cost Cutting by NHS Leads to Patients Being Deprived of Basic Surgical Procedures, Warn Leading Doctors

The Telegraph has reported that leading doctors are worried that basic surgical procedures are being denied to thousands due to NHS cost cutting. Although the Department of Health insists that many of the surgical procedures are outdated by other operations or medication, the concerns have been raised to suggest that cash savings are a stronger motive than patient well-being.

The individual health trusts decide on the provision of treatments, but surgeons say some procedures are being scrapped across the NHS. Even if patients are referred to a hospital consultant, they could at that stage still be refused an operation.

The news highlights the need for a close monitoring of the NHS’ cost cutting. In order to ascertain where the costs of a treatment outweigh the benefits, we must be able to see exactly how much a treatment costs to carry out – and not an average amount, but the precise calculations, so that we are able to compare this with the advantages that the patient would receive.

Patient level costing allows trusts to see exactly how much is spent on particular treatments, drilling down to the minutes spent in surgery, the cost of the attending staff and tie spent in a hospital bed.

Only through use of accurate figures can we hope to truly see where cost savings can be made, allowing consultants to consider the best course of treatment for individual patients.

New £44m Patient Management IT System for the NHS Scotland

The BBC has reported that a new £44m patient management IT system is being considered in Scotland to allow for the transition to be made to a paperless NHS.

Up until now, all Scottish health boards have used different systems, but this new system would be shared by all hospitals, making it more efficient to manage patient bookings and waiting lists. The aim of the new system is to replace paper processes, improve security and free up time for staff.

So far six NHS boards have signed up to the system, covering about 70% of the population. The system has already been implemented by NHS Lothian; the other boards which have signed up are Ayrshire and Arran, Greater Glasgow and Clyde, Grampian, Borders and Lanarkshire.

By creating a single system, NHS Scotland is offering the potential to streamline so many of the internal management processes, but in order for this to be successful, the software used must not only be of high quality, but it must also be accessible and easy to use.

At Ardentia, we understand how important it is for staff to be familiar with the programme they are using, as if the software is too difficult to use people will not continue with it, which creates an even bigger problem that was first encountered, as then the information is not recorded either electronically or on paper.

Trusts Risk Lower Quality Care Due to Insufficient Data

NHS trusts are under increasing pressure to make financial savings wherever possible, but in order for this to be done without impacting on the quality of care provided, trusts need to know precisely how money is being spent. The quality of data received by financial directors is crucial in determining where savings can be made, as without knowing what costs are incurred at what points of healthcare delivery, it is impossible to see how financial efficiency can be improved without putting care at risk.

Up until recently, trusts have had access to the average costs of patient treatments, but not the actual costs per patient. Patient level costing allows trusts to calculate the exact cost of any part of an individual’s treatment, so that the true cost of care can be seen and areas of inefficiency can be improved. It is only by identifying where these areas of waste lie that trusts can hope to achieve the set efficiency saving targets.

This week we issued a news release regarding the need for detailed and accurate financial data, that will help NHS trusts meet the government’s challenging budget cuts.

As the leading supplier of business intelligence tools to the NHS, we at Ardentia have developed a patient level costing solution that is already in use in a number of trusts.

Think-Tank Reform Calls for Closure of 30,000 Beds

A new report published by the centre-right think-tank Reform claims that “32,000 of the 160,000 hospitals beds should be cut”, according to The Telegraph. The independent non-party organisation has blamed the public sector deficit on over-spending on the NHS, with these bed cuts offered to remedy the situation.

The think-tank said London, the Northeast and Northwest should close more than a quarter of their beds. The report claims shedding beds is a necessary cost-cutting measure, one that would force doctors to concentrate on preventing illness and speed up the process of recovery.

The report concludes that the health service must save at least £20bn over the next five years as the large increases in funding are coming to an end. Whilst there is a general acceptance that savings need to be made, not everybody is exactly enamoured with the bed-cutting proposal. Some doctors have described the plan to cut such a significant amount of hospitals beds solely for financial savings as “immoral and catastrophic” for care in this country.

Whether these plans come to fruition or not it is clear the NHS will have to deal with the recession just like everybody else. Perhaps 30,000 beds will not go, but some cuts will have to be made.

When money is scarce, it is hugely important that systems are run as efficiently as possible. Ardentia offers cost effective and reliable solutions for managing operations, which ensure that the money available in the NHS is spent on delivering the best quality care possible.

Using Intelligence to Meet Targets

The NHS in Wales has outlined new ‘intelligent’ targets “to ensure that patients get timely access to safe, efficient and effective services”, with the distinguishing factor between these targets and the existing ones being in how these new targets are aimed at meeting quality and efficiency and not just quantity.

The idea, reports WalesOnline, is for individual health boards to be responsible for monitoring their own staff’s performance, but as opposed to the ‘intelligent’ targets just referring to time deadlines, they will also refer to “specific aspects of a patient’s care – for example the first target in the management of a patient suffering a transient ischaemic attack (TIA) include giving them aspirin immediately.”

What the Welsh Assembly Government is trying to promote is the importance of tailored care that offers the best results for every patient according to their individual needs, which is delivered both effectively and efficiently.

These targets highlight the importance of managing patients’ pathways of care as well as individual episodes. Ensuring a patient receives the next step of their treatment within a certain timeframe should not be about box ticking, the focus should be on people, not paperwork.

However, in order to manage patients’ care to the highest level there needs to be a reliable and efficient data management system in place, to make sure that while targets are being met, the focus remains on the patients.

‘Implied Consent’ Causes Controversy Over NHS Database

The NHS has been accused of “jeopardising its relationship of trust with patients” reports The Guardian, after doctors speculate about the safety of patients’ medical records on the organisation’s newly created online database.

The idea is for the NHS to create an online summary of care record (SCR) for more than 50 million people in England to “improve the quality and safety of treatment provided by hospital staff and out-of-hours doctors by giving them access to information usually only held by a patient’s doctor”.

However, the process of gaining patient consent for this has cast a shadow over the project. Patients are implied to have agreed to the creation on an SCR unless they state otherwise, but some are questioning whether the public are receiving enough detail about this project to be aware of their rights.

While it is true that security for personal information held in the public sector may not have the best track record, we must remember the benefits that an SCR database would allow for treatment on the NHS. Having access to such information could be the difference between life and death in some cases, not to mention the number of man hours that could be saved in researching and verifying medical information in emergencies.

Clearly patients need to be well educated on the programme and the exact details of how and where their data will be stored and who will have access to it, but if we are not careful, we risk wrapping so much red tape around the project that the obstacles to recording the data may prevent it from ever offering any benefits.

Leeds Receives Cash Injection to Help Cut Mental Health Waiting Times

Mental health bosses at Leeds Partnerships NHS Foundation Trust have invested £300,000 to help reduce waiting times for patients, with some currently having had to wait up to 18 months for treatment, as reported in the Yorkshire Evening Post.

The money is to help clear the backlog of the hundreds of patients still waiting for treatment, while also creating an improved and streamlined working formula for going forward – the trust is setting its own target of 18 weeks for every patient to commence treatment. Previously, there were separate treatment teams within Leeds Partnerships NHS Foundation Trust, which have now been combined into one team.

Perhaps more than any other sector of care, mental health can pose many challenges in managing pathways of care, as there are long-standing and complex needs to be met, which require the relevant services to be brought together at the right time. For this to be achieved, excellent communication between the different services is vital.

For Leeds, the streamlining of the different treatment teams into one should automatically improve communication levels, but in order to ensure that the new 18-week targets are met, there must be well maintained and detailed data management.  

Ardentia’s business intelligence solutions offer trusts the ability to record all patient information in a single, online data warehouse – making it accessible to the various service teams no matter their location. In addition to reviewing and sharing patient data, clinicians and consultants can also see the time taken for treatment referrals and can ensure that all patients are on target for treatment within the target timeframes.

Tories Propose Shake Up for Delivery of Care

Shadow Health Secretary, Andrew Lansley, has outlined the Conservative’s plans for increasing efficiency in the NHS should the party be elected in the coming months. Writing in Policy Review Magazine, Mr Lansley highlights equality, efficiency and excellence as the three key target areas for the party, with opening up the NHS to increased competition seemingly a central factor to achieving this success.

The suggestion made by Mr Lansley is to allow approved charities and private organisations to directly compete with NHS hospitals for the provision of care to guarantee “care is provided by only the most efficient and effective organisations”. The creation of a competitive market is to ensure NHS hospitals streamline productivity in order to remain as the care provider, although with the contrasting funding and resources available to many private organsiations, surely this is not without risk?

It is not only external competition that the Conservatives look to invoke, however, as Mr Lansley also outlines a proposal of how hospitals will be awarded funding based on the treatment costs incurred by “efficient” hospitals – this will be the default costing model and no additional funds will be provided to those hospitals that do not make the grade.

Should the Conservatives be elected, such changes would require precise monitoring in order to have any chance of succeeding, with business intelligence central to implementation and ongoing management. Ardentia’s patient level costing solution allows clinicians and financial managers to record the exact cost of any patient treatment and calculate how this varies from the allocated government funding. This makes it easier to keep track of any discrepancies or savings, which is vital to effective and efficient management.

In addition to the increased pressure on hospitals, the Tories also reveal plans to charge GPs with the responsibility of managing patient care costs, making Patient Level Costing even more invaluable. Mr Langley writes: “With part of GPs’ pay dependent upon the results of their patient’s treatment, they will have a direct incentive to buy the most efficient services on behalf of their patients, because they will be able to keep any savings and use them to reinvest in their patient’s care.”

If clinicians are to play such a central role in the financial decisions of patient care then it is imperative that they have the best resources available to coordinate the treatment options that will deliver the highest quality of care. Here is where business intelligence can offer rewards not only to financial managers and clinicians, but ultimately and most importantly, it can offer great rewards to patients.

GP Survey Reveals Support for Cuts to NPfIT

A recent survey of GPs has revealed that more than half believe the National Programme for IT in the NHS is an appropriate target for cuts in the current economic climate. In the survey by Pulse magazine, over 900 GPS were questioned, with 52% indicating they would be in favour of budget cuts to the National Programme for IT.

The survey results, which are reported on E-Health Insider, show NPfIT to be the third most popular target for budget cuts behind only Darzi-centre contracts and managerial headcount and salaries.

With the election build up really starting to gain pace, NPfIT and efficiency savings in the NHS are guaranteed to be at the heart of many political discussions. The support for budget cuts to NPfIT demonstrated by these survey results is hardly surprising, as there has always been much controversy surrounding the programme. However, it is important that we do not overlook the successes that it has achieved to date, with the systems that have been implemented so far offering benefits to both clinicians and patients.

The debate over NPfIT has always been ongoing, but the next few months are likely to see the spotlight thrust onto its short-comings to provide political leverage in the run up to the election. This is despite the government having already made the announcement at the end of last year on the £500m – £600m budget cuts to the programme.

It would be easy for certain political parties to jump on the ‘anti-NPfIT bandwaggon’ in the name of healthcare efficiency savings, but in spite of its short comings, NPfIT has begun to prove demonstrable benefits that should not be easily dismissed.