There was laughter in the room when John Lister ironically described the new NHS structure as “streamlined” and shared a Guardian graphic of the new bureaucracy. It set the tone for the NUJ’s Reporting on our health services masterclass, aimed at helping health reporters get to grips with confusing changes.
Lister, senior lecturer in health journalism at Coventry University, identified some of the main issues for journalists:
- access to information
- getting that information in a timely manner
- getting a range of information – not just press releases, but also Board papers, statistics, other info that isn’t specifically targeted at the press
- access to expert analysis. (You have the info, but can you make sense of it? Is there a specialist who can put it in context or add insight?)
He spoke about the slippery nature of transparency. For example, NHS England (the new name for the NHS Commissioning Board) is relatively open to reporting, but the real nitty-gritty decisions are made by Local Area Teams (LATs). Continue reading
Enfield, Barnet and Hillingdon PCT’s are the least likely primary care trusts to refer patients diagnosed with depression for therapy, a study has found.
The findings comes in a report published by the London Civic Forum who compared how many patients with depression were referred to psychological therapy in 2011-12 in London. It was based on data found on Improving Access to Psychological Therapies Website.
Enfield PCT referred just 2% of depressed patients while Barnet and Hillingdon PCT’s referred a little over 3% each.
This contrasts substantially with other PCT’s in the capital. For example, Islington PCT referred almost a quarter of patients with depression for therapy.
The findings will come as a concern to the Clinical Commissioning Groups who will be taking over from Enfield, Barnet and Hillingdon PCT’s in less than a month.
Both Ealing and Barnet PCT have around 40,000 patients each with depression – two of the highest in London.
The study also found a correlation between PCT’s that prescribed more anti-depressant drugs and referred fewer patients to therapy.
The only two PCT’s who bucked the trend were Havering and Kingston PCT’s who prescribed a high number of anti-depressant drugs and referred a relatively high number of patients for therapy.
But the study also pointed out that there was “huge variation” in the amount of anti-depressant drugs prescribed.
This year a collection of new groups will be given responsibility for £60bn of public health spending in England: Clinical Commissioning Groups (CCGs).
With over 200 of these groups and very few health journalists in the UK there’s an opportunity for student journalists and concerned citizens to play a key role in understanding what CCGs do – and scrutinising their activities.
There are a number of potential avenues to explore, from concerns about potential conflicts of interest in the new arrangements, to issues of accountability, whistleblowing, and efficiency.
In partnership with a number of news organisations and universities, we’re building a network of journalists, students and citizens to start pulling together information, exchanging tips and leads, and pursuing questions in the public interest.
If you want to get involved, contact me on firstname.lastname@example.org or add your name via the form here.
*image from the BBC
Here are the health-related links that have caught our eyes between July 12th and September 19th:
- The transfer of NHS assets to a central company marks the end of localism | Society | The Guardian– Tied to proposals for the centralisation of local NHS assets in a new, standalone company – the antithesis of localism – the powers represent, in reality, muscular centralism. For “big society”, read big government bent on privatising an NHS estate inherited often from local councils and charities.On the planning front, Pickles has now ruled that councils can be ignored when applications for large developments are tabled. They will be determined by a fast-track process at the already overworked Planning Inspectorate. The last government established an Infrastructure Planning Commission to do just that. Pickles scrapped it.
- European Health Journalism – Online Resources for Journalists – a variety of resources from the HeaRT Training Sessions are now available to access on the European Health Journalism website
- BBC News – Pregnancy clinical negligence case payouts top £70m – A Freedom of Information request showed NHS Health Scotland closed 30 cases between January 2009 and June 2011.
- NHS centre run by private firm charges patients for treatment – Sheffield – Local News – Postcode Gazette– The Broad Street centre is branded as an NHS service – which leads patients to believe treatment is free.But the centre is actually run by private healthcare provider One Medicare, as part of a contract awarded by NHS Sheffield.
The walk-in centre is in the constituency of Labour MP for Sheffield Central, Paul Blomfield. He said he was “shocked” at the discovery, adding: “The walk-in centre is breaking the fundamental principle of the NHS – that treatment should be free at the point of use.
- Third of CCGs reluctant to become statutory bodies, PM warned | News | Health Service Journal – The prime minister and health secretary have been warned that a third of clinical commissioning groups would rather not become statutory bodies because of the burden of bureaucracy involved.
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.
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?
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?
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
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