The leaked draft NHS reforms risk register

Health Bill Transition Risk Register NC 15 Oct 10 Dept Bd Version v1

A draft version of the risk register that was prepared – but not released – as part of the Health and Social Care Bill has been leaked and is available above.

The leaked document has been widely reported on, with The Guardian noting that it suggests “Emergencies in the NHS could be less well managed under the government’s controversial health reforms”.

Other risks it reports include:

• “Greater costs if new GP-led consortiums make greater use of the private sector. “One example of area where system could be more costly is if GP Consortia makes use of private sector organisations/staff which adds costs to the overall system.”

• “A danger that the new system is set up too quickly, threatening the running of the NHS.

• “A loss of financial control. “Financial control is lost due to the restructuring of budgets distributed between or allocated to organisations within the system [to be clarified],” it said.

• “Unfavourable media coverage. “Public reputation. There is a risk that the transition will be presented in a negative light via the media. Two of the biggest risks which have already surfaced in the media are i) that the reforms will continue to be characterised through the prism of privatisation and ii) financial cuts.”

The Telegraph says

“it lists 43 points ranging from fears for staff morale to problems with transferring responsibilities through workers who are also at risk.

“The document, dated September 2010, was handed to health writer and commentator Roy Lilley after repeated refusals by the Government to publish the register.”

Anything else you can find?

The new health system visualised by the BBC

The structure of the NHS

The structure of the NHS - image from BBC News

Here’s a useful ‘before and after’ illustration of the structure of the NHS now, and as it will look (as of April 2013) after the changes implemented by the Government. It helpfully illustrates the flow of money and accountability in the new system.

Do you know of any other useful resources on the restructure?

Video: Doctor’s questions to Lansley during visit to Royal Free Hospital

The Green Benches blog about the video above showing Dr Ron Singer‘s questions to Andrew Lansley about the proposed health reforms, during his controversial visit to the Royal Free Hospital. Lansley doesn’t stop to answer.

Singer is, according to the blog, “a retired GP and President of the General Practitioner’s Union with 30 years experience”.

The video follows previous reporting of the stage management of the visit.

The structure of the NHS – link

One of the initial barriers to investigating health issues is getting your head around the apparent complexity of the UK health system and its jargon. Over at National Health Service History, however, Geoffrey Rivett has put together one of the clearest guides I’ve seen on its various parts and how they connect together, regularly updated to boot (the latest being in November 2011).

The page on A guide to the NHS is worth reading in full for those looking at health issues for the first time, setting out some of the key distinctions (such as that between primary and secondary care), how money flows, and where responsibility sits. Continue reading

NHS trust performance and patient ratings – data

NHS Local have launched a service to search for NHS trust ratings and performance data. Sadly there doesn’t appear to be a link to the full data, so we’ll work on scraping it if someone else doesn’t get there first.

The email about the service promises more data to come:

“NHS local plans to expand the service by creating star-ratings on the performance of  GPs.  We also intend to offer more detail about the hospital trusts, showing data and patient satisfaction about specific treatments, such as knee or hip operations. The feedback from patients is not yet being shown in realtime, but we are working towards that.”

And there’s a contact area to give feedback – let them know we want the raw data!

Public health spending now and to come – data and documents

NHS public health spending per head 2010-11 mapped to local authorities by local authority index of deprivation

Data visualised by David Buck: NHS public health spending per head 2010-11 mapped to local authorities by local authority index of deprivation

Next year a huge chunk of money for health improvement services will be taken from local NHS bodies (PCTs – primary care trusts) and given to local government (councils) instead.

As a result, as David Buck explains, the Department of Health has had to quickly find out – for the first time – how much money is being spent on public health, so that it knows how much it needs to reallocate – and the result is particularly useful if you’re interested in previous spending or how it might change under the new system. Continue reading

How does the General Medical Council work?

The General Medical Council [GMC] was established by the Medical Act 1858 and is entrusted with regulating the UK’s medical profession. It is also a fee-based Charity [Number 1089278].

Despite its role in investigating alleged misconduct and imposing sanctions on doctors who step out of line, the GMC is not a court. Rather, it is a quasi-judicial body, as established by GMC v BBC 1998.

The distinction is subtle, but significant in respect of which laws apply to the GMC’s actions. Continue reading

Data: GP patient lists – now with QOF data

Following Sunday’s post on GP patient list data and possible avenues to explore, Carl Plant has added Quality Outcomes Framework (QOF) data, which provides extra context on the prevalence of particular conditions in each surgery’s population, as well as other data such as age distribution. You can find the combined Google spreadsheet here, or the same data in Fusion Tables here.

Let us know if you do anything with it – or have questions.

Want to investigate GP patient lists?

UPDATE (Feb 24 2012): You can find GP surgery-level data on demographics and other contextual information on the NHS IC Indicators site.

We’ve been following developments related to GP patient lists and proposals to abolish GP boundaries for a while, and this week saw some particularly interesting developments .

Pule reported that Department of Health advisory body Primary Care Commissioning had issued guidance on “brutal new GP list cleansing targets next year”:

“[T]he guidance lists successful list-cleansing schemes and gives examples of targeted campaigns in South Gloucestershire, South West Essex and Berkshire West which resulted in the removal of 24,000 ghost patients.

“They include sending verification letters to all patients aged over 90 to 100 years and annually to all immigrants. If they do not respond, then these patients will be given a FP69 flag to inform their GP the patient will be removed from their list.

“They also say anyone who is out of the country for three months or more should be automatically struck off GP lists and that multi-occupancy dwellings should be targeted.”

Meanwhile Eastlondonlines reported on 2 of the 6 places chosen to pilot abolishing GP boundaries for a year from the beginning of April. These are: Continue reading