The new NHS: what it means for journalists

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
  • transparency
  • 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

Barnet, Enfield and Hillingdon refer less than 4% of depressed patients

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.

Volunteers needed! scrutinising CCGs

CCG structure image from BBC

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 paul@helpmeinvestigate.com or add your name via the form here.

*image from the BBC

Health news roundup for September 19th

Here are the health-related links that have caught our eyes between July 12th and September 19th:

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?

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

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