Showing posts with label patient care. Show all posts
Showing posts with label patient care. Show all posts

Friday, November 15, 2013

Personalised GP care will bring back old-fashioned family doctors

Giving millions of elderly people a dedicated GP personally accountable for their care around the clock will bring back the era of the old-fashioned family doctor, Health Secretary Jeremy Hunt announced today.
Under changes to their contract with the NHS, GPs will ensure the four million patients aged 75 or over will get all the treatment they need for physical and mental conditions.
Other key changes introduce more transparency over practices’ earnings and performance, greater patient choice and fairer pay.
The new contract for 2014/15 was agreed between the British Medical Association’s General Practice Committee and NHS England, directed by the Department of Health.
Personalised care
GPs will oversee personalised care plans integrating all services, so the frail and elderly are better cared for in the community, reducing hospital admissions.
Out of five million emergency admissions last year, one third were people over 75, and more than one million could have been avoided.
GPs’ new responsibilities will include:
offering patients same-day telephone consultations;
offering paramedics, A&E doctors and care homes a dedicated telephone line so they can advise on treatment;
coordinating care for elderly patients discharged from A&E;
regularly reviewing emergency admissions from care homes to avoid unnecessary call-outs in future; and
monitoring and reporting on the quality of out-of-hours care.
It is hoped this service will eventually be offered to millions more vulnerable people with long-term conditions that need more support.
Secretary of State for Health, Jeremy Hunt said:
“The 2004 GP contract broke the personal link between GP and patient. It piled target after target on doctors, took away their responsibility for out-of-hours care and put huge pressure on our A&E departments. This government has a plan to sort this out and today’s announcement of a new GP contract is a vital step.
“We are bringing back named GPs for the vulnerable elderly. This means proper family doctors, able to focus on giving elderly people the care they need and prevent unnecessary trips to hospital. Rigorous new inspections of GP surgeries will mean every local person will know whether they are getting the care they deserve.
“This is about fixing the long-term pressures on our A&E services, empowering hard-working doctors and improving care for those with the greatest need.”
Chair of the Council of the Royal College of General Practitioners, Dr Clare Gerada said:
“This is welcome news for patients and for GPs as it will help us to get back to our real job of providing care where it is most needed, rather than more box-ticking.
“It is not the remit of the College to get involved in contractual negotiations, but we have been calling for this for three years and are pleased that the Government and the BMA have been able to reach a solution that is workable for doctors and, most importantly, focuses our time on improving the care that our patients want and deserve.”
Tick box targets
To free up more time for doctors to devote more time to patients, burdensome GP tick box targets will be scrapped.
There will be a reduction of more than a third of the Quality Outcomes Framework (QOF), which dictates how GPs should test and treat patients for specific conditions, such as diabetes and heart disease.
Getting rid of this rigid, one-size-fits-all approach will improve patient care as doctors will be trusted to use their professional judgement and make decisions based on what each individual patient specifically needs, taking all their conditions into account.
The money GPs currently earn from meeting these targets will instead be pumped into overall budgets and enhanced services.
Transparency
GP practices will publish results of a rigorous new inspection regime in surgery waiting rooms.
The Care Quality Commission’s chief inspector of general practice, Steve Field, will develop an easy-to-understand ratings system based on four categories: Outstanding, Good, Requires improvement, and Inadequate.
GPs will also look at how to publish details of their earnings.
Choice
Practices will also be freer to recruit patients from outside traditional boundaries, giving patients greater choice, informed with more information.
Patients will also be given a clearer voice to feed back their views and experiences with the introduction of the Friends and Family Test to general practice.
Other improvements to GP patient services will include making it compulsory for surgeries to offer appointments and repeat prescriptions online.
Pay
Automatic pay rises for older doctors will also be phased out as part of the government’s drive to get rid of progression pay across the public sector.
The £80 million cost of seniority payments, which are tied to length of service and average £6,000, will be re-invested in general funding for practices, based on the amount and types of patients they serve.


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Friday, June 14, 2013

Doctors should be able to veto treament data until 'happy' with it, say surgeons


Doctors should be able to veto the publication of data showing how their patients fare after treatment until they are "happy" with the figures, the Royal College of Surgeons has said.

Hunt: doctors who refuse to publish patient data will be named and shamed
Mr Hunt's intervention provoked fury from the Royal College of Surgeons Photo: PA
Robert Winnett
By , and Rowena Mason
9:39AM BST 14 Jun 2013
Comments30 Comments
Professor Norman Williams, president of the surgeons' group, said some doctors are concerned the data is not "reliable and robust" enough, given the complexities of their work.
His comments come after Jeremy Hunt, the Health Secretary, said there was “no valid reason” why doctors should be able to stop the release of the information, which would help patients identify the best place for treatment.
The Government is preparing to "name and shame" surgeons who refuse to make their data public.
It comes after the Daily Telegraph disclosed that doctors were secretly being given the opportunity to opt out of new Government league tables next month.
However, the Royal College of Surgeons has said the plan to name and shame doctors risks undermining public confidence and "stigmatising" them.
Professor Williams said the medical profession is committed to publishing surgical data, but there is a risk some doctors could shy away from doing difficult operations to keep up their good records.
He said the "way forward" is for all surgeons to publish their data when they are "happy with it". Only a small minority are vetoing publication, he added.
The first data – covering ten different surgical specialisms – will be released imminently before the transparency drive is extended throughout the NHS.
However, 92 surgeons have so far vetoed the publication of “their” data. Many are thought to have death rates which are worse than the average.
NHS England refused to name the surgeons and Mr Hunt has now ordered his officials to draw up plans to “name and shame”.
He said: “Subject to proper risk adjustment of the data there can be no valid reason why it should not be published – and the majority of consultants strongly support the case for doing so.
“In an era of public concern over patient safety issues at Mid Staffordshire Hospital, this will be a major step forward in restoring public confidence.”
Senior health officials said that the public can “draw their own conclusions” about whether they wish to be treated by those withholding data about performance. Whitehall sources have described the situation as “farcical”.
This newspaper disclosed that the surgeons were being privately contacted and asked if they wish to opt out of the publication of so-called “outcomes data”.
The Royal College of Surgeons said that its members were being asked to give their consent to comply with data protection laws.
However, it has now emerged that the Government has not even sought legal advice to establish whether this is the case – but relied on the advice given to it by the professional bodies.
Stephen Dorrell, a former Conservative Cabinet minister who chairs the health select committee, said the law should be rewritten if it was preventing full disclosure. “If it’s true that the Data Protection Act cuts across the principle of professional accountability as it needs to be applied in the modern world, then in my mind it’s very clear that the Data Protection Act needs amendment.”
On Thursday NHS England released further details of the approval process which will lead to the data being published, or withheld. For reasons which are unclear, surgeons with average survival or recovery rates will automatically have their data published unless they raise objections – but those with poor mortality rates will be asked to give explicit approval to publication.
Mr Hunt had hoped that the new system would drive up standards across the NHS and save hundreds of lives by embarrassing those with poor records.
Prof Norman Williams, the President of the Royal College of Surgeons, said the College was “not there to defend 'bad’ doctors, or those who are not performing as well as they should. Patients have a right to know of doctors who are not meeting the standards expected of them.
“We always expected this information would be mandated but it was the Government’s own legal advice, taken earlier this year, that made it clear that in preparation for the publication of data from nine national surgical clinical audits, they would have to ask for doctors to consent to the use of their data, under the Data Protection Act of 1998.
“We would urge the Government to work with us on this, for the sake of better patient care and more transparency.”

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