Useful health links for October 30th to November 19th

Here are the health-related links that have caught our eyes between October 30th and November 19th:

  • BBC News – Consultants warn care hit by poor deals on supplies – For this investigation, Ernst and Young looked at 10 NHS hospital trusts out of 166 – and found the prices paid for the same box of medical forceps ranged from £13 to £23.

    For an identical box of blankets the lowest price was £47, the highest more than £120.

  • CCG constitutions – frequently asked questions – Guidance from law firm Hill Dickinson
  • Jimmy Savile scandal shows mental health inpatient voice is crucial | Society | The Guardian – Is it any wonder, then, that the last CQC survey of psychiatric inpatients in 2009 found that fewer than half of them reported always feeling safe on psychiatric wards? And yet they have abolished the only means by which many patients can express their concerns and hope to be listened to.

    It is only in numbers that the ignored can hope to make an impression. When the first few women began to speak up about Savile's behaviour, his nephew, Roger Foster, was brutally dismissive, describing himself as "disgusted and disappointed" that such claims were being made. With a further 300 people now stepping forward, his tone has changed markedly.

    The charity, Rethink Mental Illness, has launched an e-campaign to persuade the government to reintroduce the mental health inpatient survey. It can be accessed via its website, and I would urge you to sign it.

  • Changes to the GP contract for 2013-14 | Department of Health – These proposals have been sent to the British Medical Association for consideration and include:

    new measures to improve care for patients with long term conditions and help prevent unnecessary emergency admissions to hospital
    ensuring that quality rewards for GPs reflect expert advice, from NICE, so that patients receive the very best care in line with the most up to date evidence
    stopping additional rewards for organisational tasks like good record keeping, which should be part of any good health organisation. This money will instead go into rewarding the quality of services that GPs offer patients.
    ensuring that more patients benefit from best practice in areas such as keeping blood pressure low and reducing cholesterol levels, especially those in most need or hardest to reach.

  • HSJ Briefing: general practice services and policy – The DH also last week set out to make significant changes to the quality and outcomes framework. If they are enforced, practices would have to provide a new set of enhanced services, directed by the DH and NHS Commissioning Board, to continue earning the same income. They would also be required to step up performance on QOF measures, many of which are focused on population health and prevention.

    The department has not said what the new enhanced services would be but it is expected they would include:

    A requirement to risk-stratify their population for likelihood of illness and deterioration, and provide support/attention to them
    Improving services for those with chronic conditions and for older people
    Promotion of patients’ self care, including through access to their own records.

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

Link: “Open but full” GP lists

The BMJ reports on the announcement of plans to “remove incentives for general practices to have “open but full” patient lists”. It explains:

“Currently if a practice wants to close its patient list and stop accepting new patients it risks losing the right to provide additional and enhanced services. As a result some practices keep their list open but stop accepting new patients, declaring their list “open but full.”

“This term is not legally recognised within the contractual arrangements for GPs and is confusing to patients, the health department has said.

“… The department also plans to give practices more say over the closure period and allow practices to reopen their lists when they choose, subject to a notice period. However, practices will no longer be able to open or close their lists according to growth or contraction of their patient population, the so called “ping pong” arrangements.

GPs’ patient lists are an issue we’ve covered previously on HMI Health. In September we published data on patient lists (we now have national data covering 4 years) and in January we profiled the One GP’s Protest blog, which talked about the problems with registration policy and the move to remove boundaries to GP practices, the scheme which these announcements are intended to support.

If you want to help investigate either patient lists or boundaries, get in touch.

Link: the One GP’s Protest blog

If you’re interested in issues related to GPs, it’s worth taking a look at George Farrelly’s One GP’s Protest blog. George talks about his own concerns based on his experiences of being a GP, as well as points he’s spotted elsewhere in the online health community.

These include the pilots on removing boundaries to GP practices (“The ultimate aim (covert) is the de-regulation of English general practice”) and experiences on trying to deliver care to a patient at a distance, with a more detailed exploration of the issue here.

He’s also written about the problems with registration policy – an issue I’ve been exploring myself. In particular, he talks about the 2004 GP Contract, a useful document for anyone exploring issues relating to general practice.

Which makes me think – a post explaining the contract would be particularly useful. Would anyone like to blog about the 2004 Contract? 

Data: patient numbers by GP practice in Birmingham East and North

As part of an investigation into GP surgery sizes in Birmingham I’ve collected some initial data on GP sizes from Birmingham East and North Primary Care Trust.

The data was gathered through submitting an FOI request after direct approaches took too long.

The response to the FOI request with a link to the spreadsheet is available here.

It gives patient numbers for GP surgeries as of the end of June: these vary wildly from over 37,000 at the biggest surgery to a few hundred at the smallest.

Sadly the key information – how many GPs are employed at each surgery to respond to those patients – was not supplied. The accompanying email did mention 367 GPs on the medical performers list, which averages out at 4.7 per surgery – but it’s also not clear how many of those are employed full time or, indeed, practising at all.

I am now waiting for the remainder of the data requested.

UPDATE: I’ve just discovered a PDF with GP practice data for the whole of England on the Prescription Pricing Division’s FOI disclosure pages. Seems that may have been a better avenue than individual PCTs. Now, to extract that data from the PDF…

In the meantime, here’s a quick visualisation of the data using Google Fusion Tables. Those in the top quartile of surgeries based on patient numbers have a large red marker; those in the third quartile (above average) have a large yellow marker. Those in the second quartile (below average) have a small green dot; and those in the bottom quartile have a small blue dot. It doesn’t really tell you anything other than where to look, and that possibly there are more large surgeries in the north than the south.