An evidence summary produced by NHS Bolton Library. Please click on the link to view. This is an original piece of work. Please contact the library if you wish to re-use in any format
Please find below a selection of the most relevant and interesting news stories of the past week. Including:
Commissioning
Primary Care
Public Health
via Lansley’s NHS “reforms” | BMJ.
This article is available freely via Open Access. Please click on the above link to view it fully.
As the editors of the BMJ, Health Service Journal, and Nursing Times, we have divergent views on the government’s NHS reforms and its beleaguered Health and Social Care Bill. But on one thing we are agreed—that the resulting upheaval has been unnecessary, poorly conceived, badly communicated, and a dangerous distraction at a time when the NHS is required to make unprecedented savings. Worse, it has destabilised and damaged one of this country’s greatest achievements: a system that embodies social justice and has delivered widespread patient satisfaction, public support, and value for money. We must make sure that nothing like this ever happens again.
This article is solely the work of the HSJ. For a full copy of the article please contact the library.
NHS Confederation chief executive Mike Farrar has warned the health service’s capacity could be reduced to “dangerously low levels” by proposals to halve the number of managers in key areas of NHS commissioning and planning.
This article is available freely via Open Access. Please click on the above link to view it fully.
Objectives To compare the timelines and recommendations of the Scottish Medicines Consortium (SMC) and National Institute of Health and Clinical Excellence (NICE), in particular since the single technology assessment (STA) process was introduced in 2005.
Design Comparative study of drug appraisals published by NICE and SMC.
Setting NICE and SMC.
Participants All drugs appraised by SMC and NICE, from establishment of each organisation until August 2010, were included. Data were gathered from published reports on the NICE website, SMC annual reports and European Medicines Agency website.
Primary and secondary outcome measures Primary outcome was time from marketing authorisation until publication of first guidance. The final outcome for each drug was documented. Drug appraisals by NICE (before and after the introduction of the STA process) and SMC were compared.
Results NICE and SMC appraised 140 drugs, 415 were appraised by SMC alone and 102 by NICE alone. NICE recommended, with or without restriction, 90% of drugs and SMC 80%. SMC published guidance more quickly than NICE (median 7.4 compared with 21.4 months). Overall, the STA process reduced the average time to publication compared with multiple technology assessments (median 16.1 compared with 22.8 months). However, for cancer medications, the STA process took longer than multiple technology assessment (25.2 compared with 20.0 months).
Conclusions Proportions of drugs recommended for NHS use by SMC and NICE are similar. SMC publishes guidance more quickly than NICE. The STA process has improved the time to publication but not for cancer drugs. The lengthier time for NICE guidance is partly due to measures to provide transparency and the widespread consultation during the NICE process.
via NHS watchdog is failing patients and unfit for purpose, MPs are told | BMJ.
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The NHS’s main regulator the Care Quality Commission (CQC) is letting down the public with too wide a remit and too little capacity, MPs have been told.
A response can be found here .
This article is solely the work of the HSJ. For a full copy of the article please contact the library.
This article is available freely via Open Access. Please click on the above link to view it fully.
Objective To determine whether the quality of press releases issued by medical journals can influence the quality of associated newspaper stories.
Design Retrospective cohort study of medical journal press releases and associated news stories.
Setting We reviewed consecutive issues (going backwards from January 2009) of five major medical journals (Annals of Internal Medicine, BMJ, Journal of the National Cancer Institute, JAMA, and New England Journal of Medicine) to identify the first 100 original research articles with quantifiable outcomes and that had generated any newspaper coverage (unique stories ≥100 words long). We identified 759 associated newspaper stories using Lexis Nexis and Factiva searches, and 68 journal press releases using Eurekalert and journal website searches. Two independent research assistants assessed the quality of journal articles, press releases, and a stratified random sample of associated newspaper stories (n=343) by using a structured coding scheme for the presence of specific quality measures: basic study facts, quantification of the main result, harms, and limitations.
Main outcome Proportion of newspaper stories with specific quality measures (adjusted for whether the quality measure was present in the journal article’s abstract or editor note).
Results We recorded a median of three newspaper stories per journal article (range 1-72). Of 343 stories analysed, 71% reported on articles for which medical journals had issued press releases. 9% of stories quantified the main result with absolute risks when this information was not in the press release, 53% did so when it was in the press release (relative risk 6.0, 95% confidence interval 2.3 to 15.4), and 20% when no press release was issued (2.2, 0.83 to 6.1). 133 (39%) stories reported on research describing beneficial interventions. 24% mentioned harms (or specifically declared no harms) when harms were not mentioned in the press release, 68% when mentioned in the press release (2.8, 1.1 to 7.4), and 36% when no press release was issued (1.5, 0.49 to 4.4). 256 (75%) stories reported on research with important limitations. 16% reported any limitations when limitations were not mentioned in the press release, 48% when mentioned in the press release (3.0, 1.5 to 6.2), and 21% if no press release was issued (1.3, 0.50 to 3.6).
Conclusion High quality press releases issued by medical journals seem to make the quality of associated newspaper stories better, whereas low quality press releases might make them worse.
via PCT staff letters to omit passage on clarity | News | Health Service Journal.
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Official letters to be sent to primary care trust staff about the future of their jobs this month have undergone a change in wording, with passages discussing an ongoing lack of clarity removed from the text
‘Animateurs’ and animation: what makes a good commissioning manager?.
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Objectives To examine the managerial behaviours adopted by commissioning managers in English primary care trusts (PCTs), and to explore the impact of these behaviours.
Methods Qualitative case studies were undertaken in four PCTs, focusing on staff engaged in the commissioning of hospital services. Both formal and informal observation were undertaken (150 hours), and 41 in-depth interviews conducted with managers and general practitioners (GPs).
Results Managers adopted many managerial behaviours familiar from the literature, including sharing information, and networking inside and outside the organization. Multiple organizational layers and unclear decision-making processes hindered this activity. In addition, some managers with responsibility for facilitating practice-based commissioning (PbC) adopted a managerial mode that we have called being an ‘animateur’. This approach involved the active management of disparate groups of people over whom the manager had no authority, and appeared to be a factor in determining success. It was facilitated by managerial autonomy and was more prevalent where managers were seen to have legitimacy. Some organizational practices appeared to inhibit its development.
Conclusions From 2012/13 it is planned that GPs will be taking more responsibility for commissioning in the English NHS. This research suggests that managers of the new commissioning organizations will require a deep and contextualized understanding of the NHS and that it is important that organizational processes do not inhibit managerial behaviour. Legitimacy may be an issue in contexts were managers are automatically transferred from their existing appointments.
via NHS reforms are obstructing the push for efficiency gains, say MPs | BMJ.
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An influential committee of MPs this week claimed that the government’s radical restructuring of the NHS in England was obstructing the service’s quest to save £20bn (€24bn; $31bn).
via Doubts cast over size of topline public health budgets | News | Health Service Journal.
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Warnings have already been sounded that the £2.2bn funding due to be ringfenced for councils to spend on public health will be insufficient for them to achieve better results than primary care trusts
via Lansley defends reforms from ‘unfair and out-of-date’ report | News | Health Service Journal.
This article is solely the work of the HSJ. For a full copy of the article please contact the library.
Health secretary Andrew Lansley has defended his reorganisation of the NHS, describing a highly critical report by MPs as “out of date” and “unfair” to the health service.
Pressure is building on ministers over the NHS reforms in England after a critical report by MPs has added to the mounting concerns.
via BBC News – NHS shake-up: Pressure building after critical report.
via Health committee: NHS could miss savings target from salami slicing | News | Health Service Journal.
This article is solely the work of the HSJ. For a full copy of the article please contact the library.
The NHS has been making “short-term” and “salami slicing” spending cuts and will not make required efficiency savings if the current approach continues, the House of Commons health committee has said
An evidence summary produced by NHS Bolton Library. Please click on the link to view. This is an original piece of work. Please contact the library if you wish to re-use in any format.
