Smart Healthcare: Smart Healthcare + News | SmartHealthcare.com

BT takes 43% of CfH spending

SA Mathieson — Wed, 08 Sep 2010 08:00:00 GMT

Connecting for Health spent £470m with BT last year, more than twice as much as went to CSC

BT's dominance of health service IT has been revealed by government figures showing the firm received more than two-fifths of NHS Connecting for Health's 2009-10 £1.1bn supplier budget.

The data, released by the Department of Health (DoH) to SmartHealthcare.com, shows the UK telecoms and IT services provider was last year by far the largest supplier to CfH, which runs both the National Programme for IT (NPfIT) and legacy services from its predecessor, the NHS Information Authority.

BT is one of the two key suppliers to NPfIT, but the other, US-based CSC, received just £213m in 09-10. This is despite the two firms each holding contracts to supply NPfIT with services with a total value of around £3bn.

A spokesperson for the DoH told SmartHealthcare.com that CfH pays providers for services on delivery, "not for just hanging around".

"We ensure suppliers are only paid when they have successfully delivered. The delivery of services in 2009-10 by BT are reflected in the payments due in 2009-10," she said.

Last year saw BT win a £546m deal to install Cerner Millennium at three acute hospitals and maintain it at seven more in the south of England, as well as installing CSE's RiO software at 25 mental and community health trusts across the same region, following Fujitsu's exit from NPfIT. MP Richard Bacon has recently asked the National Audit Office to investigate the deal, claiming it should have been worth around £100m.

The DoH data also reveals that despite being sacked from NPfIT in 2008, Fujitsu continues to be CfH's fourth largest supplier, receiving £37.7m in 2009-10. This is due to the "transitional period" from when the contract was cancelled, the DoH said.

"The charges figure reflects services that were provided by Fujitsu under its contracts," the spokesperson added.

In third place is reseller Bytes Technology Group, which did £57.9m of business with the agency.

The department provided data on the 100 largest suppliers to NHS Connecting for Health in 2009-10 following a Freedom of Information request from SmartHealthcare.com.

The response also said that the estimated total cost of NPfIT, including spending by local NHS trusts as well as CfH, had reached £5.829bn by 31 March 2010. This included spending of £1.091bn during 09-10 and £1.188bn in 08-09.

Additional reporting by Sade Laja

Profiles of the largest 20 suppliers to Connecting for Health

List of the top 100 suppliers to Connecting for Health

Comment

SA Mathieson

Royal Cornwall launches breast screening software

Tue, 07 Sep 2010 13:46:13 GMT

Royal Cornwall Hospitals NHS Trust has gone live with breast screening software from National Programme for IT provider CSC

The trust said that its breast screening service unit is the first in the south west peninsula region to go fully digital by using the new software to integrate technology from GE and Siemens and its Picture Archiving Communication System (Pacs).

Royal Cornwall said that the main spending on the move from film to digital imaging for mammography will be at its Mermaid Centre in Truro, which has three static mammographic units that annually provides breast screening for 25,000 women.

"I believe the 700 healthcare professionals who have access to Pacs – including ward sisters, GPs, radiographers and surgeons – will not only find the digital imaging quality better but also far more convenient to work with," said Alan Brimacombe, clinical imaging Pacs manager for the trust.

"It's a huge leap forwards for healthcare professionals across the region to be able to share mammograms and other test images. Film would generally just sit in one place but now we can distribute a wide variety of imaging data around the region to where it is needed and, crucially, they can do this on one system with one log-on so they don't have to jump between different software packages."

Although the screening equipment is based in Truro, the Pacs suite links 11 healthcare centres in the region. The trust said it asked CSC to coordinate putting together a package of digital mammography for processing and storage equipment from multiple vendors under its role as the local service provider for Pacs in the region.

Royal Cornwall said the new technology will also facilitate "full integration" between its Pacs solution and the National Breast Screening System, which is part of a key deliverable set by the Department of Health to enable all breast screening units across England to become digital by the end of 2010.

Scottish NHS tenders for audiology system

Thu, 02 Sep 2010 15:04:50 GMT

NHS National Services Scotland (NHS NSS) has published a tender worth up to £1m for the provision of a computerised audiology system

The four year framework agreement is on behalf of NHS Lanarkshire, but NHS NSS said that other health boards with similar requirements will be able to access the contract.

"NHS Lanarkshire's audiology service operates across multiple sites, and a key requirement is for the system to operate efficiently over a wide area network providing access to information which is updated in real time," the service said.

"The ability for the system to integrate with other third party applications and business processes that influence the operations of the audiology service are of high importance."

NHS NSS said it envisages that a total number of five suppliers will participate in the framework.

Other Scottish NHS organisations that may be included in the deal include: Ayrshire and Arran; Borders; Dumfries and Galloway; Fife; Forth Valley; Grampian; Greater Glasgow and Clyde; Highland; Lothian; Orkney; Shetland; Tayside; and Western Isles.

Wales to extend telemedicine to rural areas

Wed, 01 Sep 2010 13:04:15 GMT

Some of the money from Wales' Rural Health Innovation is going to the extension of telemedicine

The Welsh Assembly Government said that 13 local projects will receive shares of £825,000 from the fund, which aims to improve access to health and social care services in rural areas through the use of new technology.

It said it wants to extend telemedicine across non-urban areas "to improve quality of care and keep healthcare local, reducing travel time for patients and health professionals".

The relevant projects will receive £525,000 from the fund, with a further £200,000 for the Hywel Dda and Powys Health Board areas to pilot integrated models of care between health and social care.

The government said that £100,000 will also be allocated for national coordination and evaluation of the rural innovation projects, and that the remaining funding will be used to support innovation emerging from the Rural Health Implementation Plan.

Other projects that will receive money include: tele-rehabilitation video conferencing in North Wales; an electronic link between x-ray departments at hospitals in Mid-Wales; and the implementation of community hubs in South and West Wales.

"The range of projects funded will help develop new ways of providing services, improving access to services for those living in rural areas. I expect that people will see a real difference as these projects are developed," said health minister Edwina Hart.

"I look forward to receiving further recommendations over the coming months on how to utilise the remaining funding."

DoH retains NHS Direct online

Tue, 31 Aug 2010 14:05:39 GMT

The Department of Health has said there are no immediate plans to drop the NHS Direct web service, despite signalling the end of telephone consultations

It has issued a statement saying that the site, which provides a first stop for medical advice, will remain in operation while the government reviews the wider use of information in the health service.

This follows the confirmation that it plans to replace the NHS Direct telephone consultation service with the 111 telephone line.

A DoH spokesperson said: "Following the publication of the white paper Equity and Excellence: Liberating the NHS, a further consultation on the NHS information strategy will inform how patients and the public will be able to access online information and services in the future. In the meantime, online services provided by NHS Choices, NHS Direct and local NHS organisations will continue to support other NHS services."

This followed reports that the department is planning to replace the NHS Direct telephone helpline. Health secretary Andrew Lansley said at the weekend that the service, which costs over £120m a year to run, is to be axed in favour of the new 111 service.

Following this, the DoH issued a statement that said: "The NHS 111 telephone number will eventually replace NHS Direct when it is rolled out nationally and will provide a single point of access for all urgent care services. This has never been available before but makes real sense."

It went on to claim: "This is not a cost cutting exercise, but is about providing a better service to patients. We want to put an end to the confusion over what services are available when and where, and provide people with two simple numbers: 999 for emergencies, 111 for everything else."

The move has attracted criticism as the 111 service will be staffed primarily by non-specialist call advisers, whereas NHS Direct uses qualified nurses.

The DoH launched the pilots for 111 in County Durham and Darlington at the beginning of last week. According to a report in The Guardian, it has just one nurse on duty for referrals with up to 25 operators at each of the two call centres used in the pilot.

Further pilots are due to begin later in the year in Nottingham, Lincolnshire and Luton.

NMC signs for IT support

Tue, 31 Aug 2010 10:21:19 GMT

The Nursing and Midwifery Council has signed a £5.2m deal for the hosting and management of its core computing infrastructure

Its five year arrangement with Business Systems Group (BSG), a subsidiary of Advanced Computer Software, will involve the hosting of its servers and networks, disaster recovery, systems monitoring, technical design and ongoing consultation.

BSG will also be provide database and operating system support, and manage NMC's Microsoft Exchange email, Citrix desktops and telephony (using Cisco CallManager).

The NMC currently has a four person in-house team providing the service, but has made the change in an effort to obtain better value for money and access to a larger pool of IT skills.

Jolyon Ingham, interim head of ICT for the NMC, said: "In addition to being able to provide an economic alternative to managing IT in house and hiring external consultants, it is clear that BSG can deliver enhanced service levels, expertise and security as well as an effective disaster recovery solution. We look forward to developing a long term strategic partnership with BSG."

Under the terms of the contract, BSG is required to ensure 99.9% service availability and timely incident management. All four NMC in-house IT staff will be transferred to work for BSG under a TUPE arrangement.
All software applications will also be hosted by BSG.

Incapacity team rolls out EPR

Fri, 27 Aug 2010 09:50:16 GMT

A partnership providing support to incapacity benefit claimants has implemented an electronic patient record system

Tees Valley Condition Management Programme (CMP), which consists of five NHS organisations in the district and the local Jobcentre Plus, has set up a system based on AxSys Technology's Excelicare software to replace a manual system.

The partnership supports people claiming incapacity benefit or employment benefit allowance who consider their health condition to be one of the barriers preventing them from returning to work. Referral to the programme is routed via an advisor at the Jobcentre into Tees Valley CMP.

The EPR, which went live in May, provides records from referral to discharge, including clinicial assessments and scoring. It is used by 19 remote workers, including administrative and management staff, nurses, occupational therapists and health psychologists operating at 12 localities.

Jayne Robson, associate director, Tees Valley CMP, said it had begun to develop a solution in-house when it discovered that AxSys had produced a similar solution for CMP in Scotland,
and found it was adaptable to its own work processes.

It has now added details of about 200 patients to the system.

Auditor calls on NHS to improve payments coding

Thu, 26 Aug 2010 10:42:27 GMT

The Audit Commission has said there are still problems with the data used to assess more than £200m of payments under the NHS's Payments by Results scheme

In a report published on 26 August 2010, the commission says it has identified some £9m of financial errors due to incorrect clinical coding used to identify how NHS trusts are paid for treatment.

The errors are most relevant to data on health resource groups (HRGs), which bring together clinically similar treatments that are judged to consumer a similar amount of resources.

The situation has improved, however. "When we started the audits in 2007-08, on average, 16.5% of diagnosis and procedures were not accurately coded," says the document. "In 2009-10, on average, 11.3% of diagnosis and procedure coding was inaccurate."

Despite the overall improvement, the actual error rate for the HRG increased in 2009-10 because most Payment by Results tariffs moved to new and more complex set of Health Resource Groups, known as HRG4.

Over the past three years the commission has carried out random sample audits on four specialities - general medicine, trauma and orthopaedics, cardiology and paediatrics - at all trusts that deliver them.

The commission has estimated that £1bn of the £21bn expenditure, or 5%, in these four specialties was paid on the wrong HRG between 2007-08 and 2009-10.

Nationally, primary care trusts were not over or undercharged for the work, however, because the average net financial error rate is less than 0.5% in the four specialities audited.

The report goes on to say that, despite the overall improvement in clinical coding, there are significant variations between the best and worst performing trusts. HRG error rates range between 0 and 28% and the clinical coding error rate range is similar.

Its key recommendations for improvement are:
- regular internal audits on clinical coding and the quality of outpatient data;
- clinical coders to be well trained and follow national standards;
- clinicians to be engaged in improving the accuracy of inpatient and outpatient data;
- up to date policies and procedures for data quality; and
- source documentation to be of a good quality, accurate and readily accessible to those inputting data.

"Our work has highlighted problems in the consistency and interpretation of national guidance and definitions that affect data quality," says the commission. "We will work this year on specific data definition issues with the NHS and key partners to look at how these can be resolved."

Maudsley tags mentally ill offenders

Wed, 25 Aug 2010 14:47:01 GMT

The South London and Maudsley NHS Foundation Trust is using satellites to track psychiatric patients with criminal convictions

The launch follows a successful 12 month pilot project in which 35 mentally ill patients at River House, a medium secure psychiatric unit at the Bethlem Royal Hospital in Beckenham, took part.

The unit now has 60 devices and plans to use the system on more patients over the coming months.

"We started using the system last year and increased the service in March, but we needed to make sure that everything had bedded in before announcing its use," a spokesperson for the Maudsley told SmartHealthcare.com.

The patients have been detained after committing a range of offences including violent crimes, arson and anti-social behaviour. They are being fitted with ankle tags linked by satellite to a control room, which alerts the hospital when a patient goes to an area they're excluded from, or is away for too long.

The system can measure whether the tracking device, and therefore the patient, is moving and at what speed. In addition, the ankle tag vibrates to remind a patient when they are nearing the end of their allotted time away from hospital.

The pilot showed that the system led to fewer leave related problems, as the trust can identify the patient's whereabouts and re-establish contact quickly. It also enabled the trust to increase the leave given to River House patients.

"Graduated leave, with increasing degrees of freedom as patients recover, is an important therapeutic process that aids re-skilling and social reintegration of people who have been in hospital, often for long periods of time," said the spokesperson. "Technology is an added assurance to a rigorous clinical and risk assessment process."

The system was developed by Buddi and each device, including straps, costs £374, plus £50 per month per device for monitoring. The spokesperson added: "We think the system will cut the costs of searching for patients who have absconded."

One of the patients who used the device while at River House said that it had helped to keep him "more safe". He now lives in a hostel after 13 years in secure hospitals following a conviction for arson.

"If I was to have an accident of any kind it would be easier to pick me up," said the patient, although he added that the tracker was uncomfortable when worn for long periods, and that: "Sometimes it makes you feel a bit childish... almost labeled."

North East launches 111 pilot

Mon, 23 Aug 2010 10:32:54 GMT

A pilot for the 111 number for non-emergency healthcare support has got under way in County Durham and Darlington

The Department of Health (DoH) has set up the 24 hour local service as a step towards a national roll out.

It said the service can be used by people who need help fast or do not know who to call, and that it will be particularly useful outside of GP surgery hours and for people who are away from home.

The service is staffed by trained advisers, working under the North East Ambulance Service NHS Trust and supported by nurses. A caller will receive an immediate assessment, with advisers directing people to the most appropriate service or, if they decided it is an emergency, despatching an ambulance.

Health secretary Andrew Lansley said: "By putting in place one, easily
memorable 111 number for all urgent inquiries to run alongside the emergency '999' number we will simplify NHS services for patients. 111 will be free to call and available 24/7, putting patients in touch with the right NHS service, first time."

He said that further pilots are planned for Nottingham City, Lincolnshire and Luton later in the year. The regions have been chosen to test different ways of delivering the 111 service using various NHS providers that include the ambulance trusts, an out-of-hours service and NHS Direct.

NHS North East announces job cuts

Wed, 18 Aug 2010 14:19:50 GMT

The jobs of over 500 managers of IT and other services are to go under plans by the North East strategic health authority to cut costs

The authority said that, together with the region's 12 primary care trusts, £27m of cost savings must be found and as a consequence it was consulting about 516 job losses.

All savings that are made will be reinvested in frontline services to pay for better treatments and new technologies.

Consultations about job reductions began on 16 August and will continue for a month.

The biggest loses are likely to be in County Durham PCT, which could lose 110 posts, Sunderland PCT, which could lose 85 posts and 82 from Middlesborough PCT.

Nearly 40 jobs will go from the strategic health authority. "This includes all staff within the organisation's core function areas: medical, finance, communications, operations, and performance, and nursing and patient safety. This will include IT staff," a spokesperson for NHS North East told SmartHealthcare.com.

David Stout, executive director of finance and communications at NHS North East, said: "Like all public sector organisations, the NHS in the region must deliver substantial savings in order to meet the challenges of a difficult economic environment.

"The management cost reductions we have outlined will inevitably impact on many people and we are of course committed to keeping staff fully informed throughout this difficult process."

Trevor Johnston, Unison lead officer for health in the north east, said that trade unions welcome any improvements to frontline services, but pointed out that NHS managers and administrative staff "carry out important functions".

"We're very concerned that a reduction in these areas will lead to frontline staff being unable to function effectively due to lack of administrative and managerial back up.

"We are also concerned with governance issues due to these cuts in staff. The trade unions understand that these measures are imposed by the government and we are actively engaged in consulting with the employers on the changes," he said.

NHS faces £65bn PFI repayment bill

Sade Laja — Fri, 13 Aug 2010 13:50:14 GMT

The Department of Health has said that the NHS will eventually pay six times the original value of Private Finance Initiative (PFI) buildings

A spokesperson for health secretary Andrew Lansley said such payments are already increasing sharply, telling SmartHealthcare.com that the coalition government will have to pay "twice as much in PFI payments as Labour did in the last five years" over the same time period.

DoH figures show that overall unitary charge payments for PFI projects from 2010-11 to 2014-15 are expected to reach £7.2bn, compared with £3.9bn in real terms for the equivalent five year period from 2005-06 to 2009-10.

PFIs allow private companies to fund the building of hospitals and mental health units, while the NHS pays for the facilities over a number of years.

According to data obtained by the BBC, 103 PFI projects that were originally valued at £11.3bn will cost the NHS more than £50bn to repay. Once extra costs such as maintenance, cleaning and catering are considered the NHS is due to pay back £65.1bn over the lifetime of the deals, some of which last 25 years.

"Labour said they were using the unprecedented increase in NHS spending to build new hospitals, but in truth they left the bill to be picked up by us," Lansley's spokesperson said.

"Though the new hospitals which we are now paying for are welcome, other financing options should have been on the table. Our recent white paper sets out our intentions to give foundation trusts greater freedoms, which will involve their being able to access borrowing in a more flexible manner."

According to DoH data, the NHS currently pays back a total of £1.25bn each year, but this figure is expected to increase until 2030 when it will hit £2.3bn. The final payment will not be made until 2048.

The NHS budget has been ring-fenced, but the government has said that it expects the health service to make £20bn in efficiency savings by 2014.

Victor Almeida, healthcare analyst at Kable, believes that although the coalition government is committed to granting trusts more liberties including flexible borrowing and unlimited patient chargeable services, it will not be easy for hospitals to extricate themselves from PFI deals lasting years or decades.

"It will be very challenging for some trusts to spend up to 15% of their budget on PFI payments and on top of that make a further 20% efficiency savings in order to cope with our population's increasing health demands, despite the improved financial and funding freedoms," Almeida said.

He also thinks there would be "disastrous consequences" if some hospitals were allowed to go bankrupt before their PFI term was finished.

"Given the state of the economy and government austerity measures, it is extremely unlikely that new PFI initiatives will be created in the next few years. But they could certainly recur in five to 10 years, once the 'anti-previous government' rhetoric has worn off," Almeida added.

Sade Laja

Buying Solutions chooses telecare suppliers

Thu, 12 Aug 2010 12:45:26 GMT

The Cabinet Office's buying agency has appointed 61 suppliers to its assistive technologies framework

The two year framework, which will be worth up to £300m and ready for use by public sector organisations from 16 August 2010, is predicted to be worth between £50m and £300m.

The suppliers include IT vendors including Accenture, Cirrus Communication Systems, Hewlett Packard, iSoft, Red Alert Telecare, System C Healthcare and Telefonica O2. It also includes phone and web advice service NHS Direct, as well as several housing providers.

The contract is divided into six lots. The first covers telecare products, including base units connected to a telephone network or broadband, call monitoring, and personal telecare products such as activity monitors.

The second is for call monitoring and response services. Lot three provides remote monitoring hardware and software, home hubs and other personal application hosting and communication devices, such as PCs with an internet connection and smart phones.

Lot four is for off the shelf equipment, rather than bespoke technologies covered elsewhere in the contract.

The fifth lot is for video or audio conferencing between patients in the community and clinicians or care services to support the delivery of health and social care. It includes the installation and hosting of services.

Lot six, for managed services, covers the management of accounts, customer liaison and training.

Chris Pennell, principal analyst at Kable, said: "We still feel that while the framework covers some interesting areas around telecare, the value range indicates uncertainty about demand for this type of service."

Lincolnshire send A&E waits by text message

Wed, 11 Aug 2010 11:34:11 GMT

NHS organisations in Lincolnshire have created a text message service to update A&E patients about waiting times

The service, created by United Lincolnshire Hospitals NHS Trust, NHS Lincolnshire, NHS Choices, Directgov and Businesslink, was announced on 3 August 2010.

It provides patients with a free mobile service that replies to a text message with the word WAITING sent to 64746 with the latest waiting times at accident and emergency departments in Lincoln County Hospital, Pilgrim Hospital, Boston and Grantham and District Hospital and at the Lincoln walk in centre.

The NHS in Lincolnshire and NHS Choices have also created a desktop widget which provides guidance about getting the right treatment in the Lincolnshire area. They claim the downloadable tool, available on the United Lincolnshire Hospitals NHS trust website, is the first of its kind in the UK.

If a patient decides medical assistance is needed urgently, the widget also displays current waiting times in the same way as the text message service.

Peter Buckley, emergency care programme director for United Lincolnshire Hospitals NHS trust, said that both tools are designed to improve patient experiences.

"As the numbers of patients attending our A&E departments continues to rise, caring for the clinically most needy and vulnerable patients is a priority." he said.

"We hope that when patients use the waiting text alert and dashboard they can and will make more informed decisions about whether alternative care, of similar high quality, that is available throughout Lincolnshire might well be a better choice for them.

"This will free up the time of our clinical staff to concentrate on those that really need the services of an A&E department."

Government to review Dr Foster joint venture

Mon, 09 Aug 2010 13:56:09 GMT

The Department of Health is considering the future of an NHS business information provider in which it has a stake

It has announced a strategic review of Dr Foster, to be conducted by consultancy KPMG and published in the autumn. A spokesperson for the department said the review would include looking at ownership options, but that there are no predetermined outcomes.

The joint venture was set up in 2006 between the NHS Information Centre and Dr Foster Holdings, a limited liability partnership. The centre transferred its 48.75% stake to the Department of Health last month.

Doctor Foster Intelligence, which made £22.1m in 2009, provides data to UK health and social care organisations. In April it bought Dr Foster Research, with the aim of extending its business to local government, the independent sector, pharmaceutical firms and international customers.

Health minister Simon Burns said: "In the White Paper Equity and Excellence: Liberating the NHS, we set out a vision for an information revolution to give patients greater choice and control. We will publish our information strategy paper in the autumn. This review will ensure that the Department of Health is making the most of Dr Foster Intelligence."

On 5 August, the department recently said it would consider private sector investment in NHS Professionals Ltd, a company currently wholly owned by the government, which provides short term and shift staff to more than 77 NHS organisations.