NHS consultants hit out at plans to make them declare incomes from private work : i News.

This is a throw back to the start of the NHS when doctors, dentists and the BMA were against the formation of the NHS as they felt it would impinge on there then current work, which was all the equivalent to private practice. To bring them on side, so that the NHS could be formed it was agreed that they could dp private work as well as their contracted NHS contract.

I have no objections to any of them being involved in private practice work, except where this is done on NHS time. For many years I was employed in the Life Assurance industry and when we wished our customers to undergo a medical examination these were conducted by practicing GPs or hospital consultancts. From my own knowledge many of these exams were undertaken on and using NHS facilities and our customers would be in the waiting areas with NHS patients, so were being conducted on NHS time, using appointment which should have been for NHS patients.

When a consultant is late for their hospitals surgeries how do we know if this delay has been caused by over extending private consultations, with open and transparent practices this would be easily be proved or not.

Recently it has been suggested that if NHS patients wish to be seen sooner, that is queue jump, they could pay up to £70 pounds to be seen quicker. Does this imply that the doctors have spare time when they are willing to see more NHS patients for a price, at a time when we are being told doctors do not have time to do more NHS work.

Are there untruths being mentioned, full and open transparency would ease there feelings, who as what to hide.

Discredited Maximus adds care inspections to DWP portfolio | DisabledGo News and Blog

The care watchdog has been criticised for awarding a discredited outsourcing giant new contracts to manage the use of service-users as expert advisers in care homes and hospitals. Two-thirds of the new contracts to run Experts by Experience – which pays people with experience of using care services to take part in Care Quality Commission (CQC) inspections – have been awarded to Remploy. Remploy will recruit, support and manage the involvement of Experts by Experience in CQC’s north, south and London regions, while the contract for the central region has been handed to a consortium run by the charity Choice Support, which is one of five providers currently running the programme across the country. Disability News Service has also learned that Remploy is offering disabled people who work as Experts by Experience under its contract about half the hourly rate they are currently earning under the programme. Remploy, which will start delivering the Experts by Experience programme on 1 February

Source: Discredited Maximus adds care inspections to DWP portfolio | DisabledGo News and Blog

How can the performance of local health systems be assessed?

Original post from The King’s Fund

‘……………….By Chris Ham Chief Executive

Today we publish the results of our review of how the performance of local health systems could be assessed. This work was commissioned by the Department of Health which asked The King’s Fund to advise on the ‘first principles’ of a local health system scorecard for the NHS in England.

We were asked to report on the development of a health systems scorecard which would aim to:

  • allow commissioners to assess the quality and effectiveness of local services and identify areas for improvement
  • provide accountability to patients and the public, allowing them to compare local health services on the basis of objective information
  • help NHS England identify areas where clinical commissioning groups (CCGs) may need targeted support to improve care quality and health outcomes.

The review is a contribution to Secretary of State for Health Jeremy Hunt’s ambition to put ‘intelligent transparency’ at the heart of NHS performance improvement in this parliament. We believe intelligent transparency demands a clear line of sight from the Secretary of State through NHS England and CCGs to the populations they serve, based on indicators that reflect what really matters to the public and NHS priorities. This would deliver the single definition of success for local systems of care and CCGs that the Health Secretary has spoken of as being needed for providers.

To deliver this clear line of sight, we recommend radical simplification and better alignment of existing frameworks for assessing performance in the NHS. Our report also argues that there should be rationalisation of the disparate public-facing websites to provide the public with an integrated view of health and care services in an area. The public should be consulted on which aspects of performance should be covered and how information should be presented – at the moment this is an evidence-free zone.

Intelligent transparency demands careful attention to how performance indicators are selected and presented if it is to achieve its desired results. Done well, performance assessment can help to strengthen accountability to patients and the public, as well as support commissioners and providers in improving care. The challenge is to adopt an approach that recognises the complexity of performance assessment and the pitfalls that await the uninitiated.

To avoid these pitfalls, we looked at experiences in a number of other health care systems as well as in the English NHS. We recommend that information about the performance of local health systems should draw on the three national outcomes frameworks that currently exist and the commissioning outcome indicator set. This information should be presented at three levels to inform patients and the public about services in their area and to support commissioners and providers in achieving improvements in care.

The first level would focus on a small number of headline indicators aimed at providing a picture of performance for the population as a whole. The second level would be organised around the domains and indicators in the outcomes frameworks and the commissioning outcome indicator set. The third level would include a larger set of indicators to enable patients and the public to drill down into population groups and medical conditions of particular interest to them, and to support commissioners and providers in quality improvement.

Over time we recommend that the three outcomes frameworks be consolidated into a single framework covering the NHS, adult social care and public health.

One of the clearest conclusions of our review is that an aggregate score of the performance of local health systems should not be produced using performance indicators alone. Aggregate scores can mask good or poor performance on individual indicators and therefore may not give a meaningful overall picture. This was strongly supported by our review of the evidence and experience in other countries, as well as by the group of technical experts that we convened to advise us in our work.

Further work is needed to understand more thoroughly the information that the public and CCGs want, as well as how appropriate data could be presented and accessed to support the causes of transparency and improvement.

The Report              …………….’

Should we be worried about CCG conflicts of interest?

Original post from The King’s Fund

‘……………….Ruth Robertson  Fellow, Health Policy

Health organisations to display inspection ratings

Public and private health and care providers will have to display their Care Quality Commission inspection results, following new rules presented to Parliament last week.

These rules, which cover GP surgeries, care homes and hospitals, mean that the ratings will need to be displayed prominently in entrances, waiting rooms and on websites.

This is designed to strengthen transparency in healthcare, with patients being able to see how services are performing and make informed choices about their care.

You can read the government’s response to the consultation into visible ratings for health and care providers.

The CQC is asking these organisations to share their thoughts on how they can make sure they are meeting these new requirements from April.

The law is expected to come into force on 1 April 2015, subject to Parliamentary approval.’

To view original article from  Department of Health Health organisations to display inspection ratings

This is transparency in the making and hopefully will be a positive move. The Care Quality Commission (CQC) already do inspect GP surgeries, care homes and hospitals and the inspection reports have always been available to view on the CQC website. But how many of us bother to check, assuming that were we aware that this was possible.

But CQC also inspect Dentists, Community healthcare services, Clinics (family planning and slimming) Home care agencies and Mental Health services, so why does it appear that these areas are not covered by the same rules.



New laws for more open and safe care in the NHS

New laws for more open and safe care from Department of Health

An extract ‘Two new important laws to help improve patient safety, transparency, and leadership in the NHS come into force today.

The first is the statutory Duty of Candour, which places a legal duty on hospital, community and mental health trusts to inform and apologise to patients if there has been a mistake in their care which has led to significant harm.  ……’

‘……..The second new law relates to ensuring strong and safe leadership in healthcare organisations. Under the new regulations, all NHS board members will be required to undergo a Fit and Proper Person’s Test before they are appointed.  ……’

For more information follow Fit and proper persons requirement and the duty of candour for NHS bodies*

It would appear that this is welcome news, which may be long over due, but will it make a difference. Only time will tell, for, no matter how much legislation is created, if the organisations do not abide by it, then will there be any difference. Will the monitoring by CQC (Care Quality Commission) be sufficient? Are the new laws robust enough? For as stated in the Duty of Candour ‘.. a mistake in their care which has led to significant harm.’ why not all mistakes, whether there is harm or not?

We do need to trust the NHS, which currently we may do or not. But if we did not have the NHS we would all be far worse for it not being there.


Contains public sector information licensed under the Open Government Licence v2.0.

Truth and Respect

Just what is truth and respect, we hear these words mentioned in all areas from time to time, but what is the truth and do we show or have respect and do we trust.

From an early age we are informed to respect authority and to trust the Police. Now we are told no one respects authority and there is no trust in the police. So why has there been a change over the last 50 years or has there been no change, but people are now more honest about their feelings. At this early age the children are also expected to trust and respect their parents.

When I was at school some 50-60 years ago it was assumed we respected the teachers, but was fear thought to be respect. The teachers were the power and should not be crossed, as they had the punishments to deliver if you did cross them. Is that they way to have or gain respect, no you fear for what could and can be done to you. This fear is no longer there, as the punishments of long ago have been withdrawn and the pupils of today know they can do virtually anything and will not receive any punishment. This lead to large-scale disobedience and can have devastating consequences as could be seen from recent news. Teacher stabbed to death in Leeds, while this may not be a direct result in punishment removal and the no respect or fear of teachers, it is a product of what is occurring today.

Then we have the Police, this was, only a few years ago, a profession that the majority respected and looked upon with pride and trust. While there were always the occasional stories of corruption, this was isolated persons in particular forces. Now we have Hillsborough, possibly Orgreave, Stephen Lawrence and others. This is not to say that the police are corrupt, but a minority of the officers may be, but it is the manner in which these investigations and others were handled that leaves a door of mistrust open.

The NHS, this is one of the great institutions of the UK, being that it provides health care, free at point of delivery for all eligible persons within the UK. But there have been many issues, one of which is Mid Staffs. This is where there were many unexplained deaths and the extent of a cover up.

One of the biggest scandals and is still current is the child abuse allegations and Jimmy Saville and others. Here questions are still being asked about the conduct of the BBC, various hospital, including Leeds General InfirmaryBroardmoor , Stoke Mandeville and many others, CPS, Police and some child care homes.

Now Cyril Smith which again bring in, what appears to be child abuse, police investigations or no investigation and politics. Was this known at Westminster, by his own party; the Liberals  or any of the other parties or any MP’s and if it was, were there cover ups?

The mention of politics and MP’s brings in the expenses scandal, where certain MP’s were accused of claiming expenses they were not entitled to and some were prosecuted and many had to pay back the expenses they should not have had. Then we have certain persons in Parliament and Government who may not have always been truthful, this causes Tony Blair  to be mentioned his’weapons of mass destruction‘ is but one example of limited truth.

But can one believe anything a Politian says, have you observed when they are in interviews and are asked questions, have you ever seen or heard one politician answer any question directly.  In most cases the response will be superbly diverted to the response they wish to give, which in most cases has no bearing on the question being asked.

The expenses scandal was found out by media investigation, but recently the media has had its own scandals with the phone hacking, the parliamentary review and the convictions.

So many of the UK institutions have recently been found to be not telling the truth and then, does that lead to the non-respecting of these institutions, for many the answer will be yes. This, of course, does presuppose that they were, in fact, respected previously.

So how can these institution and the persons within them be seen to be trustful and then maybe respected. I believe it starts with them being  open, honest and transparent and at least one MP says he will MP Craig Whittaker. There are also a number of  NHS Hospitals and NHS organisations who have taken this on board, some being NHS England, The Rotherham NHS Foundation Trust, The Newcastle Upon Tyne Hospitals NHS Foundation TrustSalford Royal NHS Foundation Trust, but there are also others.

This is most likely following Jeremy Hunt, The Health Secretary, asking NHS Hospitals to have an open and honest reporting culture and there is a Government Press Release* on this subject.

The proof, however is yet to come and we shall see where the open, honesty and transparency will be, for it is one thing to have put the deed on paper, it is another task to deliver it by action.

For trust has to be seen to be forthcoming from all UK organisations and the people within and then, and only then, will the respect be being earned. It is then for each individual person to decide are they being given the truth, so that they can commence to trust and possibly then, in time also respect.


*Open Government Licence v2.0