nhs

Why PR firms should be banned from the NHS

jeremy huntHealth secretary Jeremy Hunt last week declared that, as far as the NHS is concerned, transparency is best disinfectant. That should be music to most journalists’ ears.

Over the last decade, there has been an incredible erosion of transparency in the NHS. As hospitals became foundation trusts, they (for a while), had the right to hold their board meetings in private.

Ambulance trusts have become regional, rather than county, wide and therefore the level of information presented at board meetings is more sparse. Strategic Health Authorities, which the Government finally scrapped in April, seemed to exist solely to take the credit for things which worked and to fog over the things which didn’t. For most of the last year, one SHA covered the whole of the North – decisions about Manchester being taken in Tyneside and vice versa. For journalists, it’s great to see the back of SHAs, although a shame that they aren’t around to take their share of the blame for the horrific incidents uncovered by the Keogh Review.

There there are the Clinical Commissioning Groups, which have replaced Primary Care Trusts. Founded on the best of intentions – to give GPs control over spending – the level of transparency remains to be seen.

So all in all, if Jeremy Hunt is serious about transparency improving the NHS, it’s a good thing. He can start by getting the Government to knock its plan to restrict access to FOI on the head. With the constant political meddling and restructuring the NHS is subject to, the one constant is FOI from an access to information point of view.

When he’s done that, he should suggest that PR firms have no place in the NHS.

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NHS Jargon part 3: How not to reassure patients when you’re being investigated for lots of deaths

Last week, the report into what went wrong at Mid Staffordshire Hospital, made for very bleak reading. It also emerged that five more hospitals were to be investigated amid concerns about a high number of deaths on their wards.

The hospitals now under investigation are ones which have reported a high ‘summary hospital-level mortality indicator’,  a government measure on hospital deaths. Of course, a high level doesn’t necessarily mean a hospital is doing something wrong – the local population could generally have poorer health than in a more affluent area, for example.

Now, given the level of publicity such an announcement is likely to make, you’d think the hospitals involved would be keen to put minds at ease with an easy-to-understand, reassuring message. You’d think. And in fairness, some were very, very straightforward. East Lancashire Hospitals NHS Trust, for example managed to put across a series of comments from senior health figures in the area in a way which was easy to take in – despite the odd reference to ‘outcomes for patients.’

Not so at Tameside Hospital in Greater Manchester, which for several years had been nicknamed Shameside by patients fed up with the service they got.

Step forward chief executive Christine Green, with this bingo-card busting string of NHS jargon posted on the hospital’s website to reassure visitors:

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Caught on Camera: Grim Reaper spotted in hospital

The Grim Reaper....In a hospital

Blink and you’ll miss it – but here’s the Grim Reaper caught on camera at the Royal Liverpool Hospital. Sort of.

It’s a screengrab from the video below, which was recorded by staff at the hospital to try and encourage people to wash their hands more frequently when in hospital. I might be being sniffy (and not just because I have a cold) here, but I never quite understand why hospitals have to keep reminding their staff about washing their hands. Newsrooms don’t have signs (or videos) saying ‘reporter, pick up your pen,’ do they?

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FOI: Has another newspaper uncovered a health-related manslaughter?

The other week, I blogged about a remarkably successful FOI request by the Brighton Argus which had revealed a previously unreported investigation into an alleged manslaughter at a hospital.

Neither the police nor the hospital trust had felt the need to make the investigation known – or highlight the fact that three members of staff have been arrested and bailed pending further investgiations into the death of the 77-year-old.

Now, the Warrington Guardian is reporting that an FOI it submitted to local health authorities has uncovered some interesting findings:

A MURDER and a child death were some of the serious incidents reported by health trusts in Warrington earlier this year.

Between April and June, 18 were logged by Warrington and Halton hospitals and The 5 Boroughs Partnership.

They were subsequently registered with health authority the National Patient Safety Agency (NPSA) and NHS Warrington.

On June 19, 5 Boroughs, the mental health trust that covers Warrington, Halton, Knowsley, St Helens and Wigan, announced that one of its outpatients had committed a murder.

It also reported on May 25 that a community patient, who was receiving treatment, had died unexpectedly.

On April 21, Warrington and Halton hospitals made NPSA aware of the child death.

The list was revealed following a Freedom of Information request lodged by the Warrington Guardian.

 

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NHS Secrecy: GP consortia to be told to meet in public

Some more good news on the NHS front: After making clear that Foundation Hospital Trusts must hold their board meetings in public, GP consortia have been told they will have to do the same as well.

When the Department of Health announced its response to a review of planned reforms to the NHS, it made very clear in press briefing notes that it intended to make Foundation Hospital Trusts hold their board meetings in public. At present, Foundation Hospital Trusts don’t have to meet in public – one of the ‘freedoms’ they were given under Labour. This change was important because the government wants to give more hospitals foundation trust status.

The DoH has now confirmed it will make GP consortia meet in public too. GP consortia are the organisations which will replace Primary Care Trusts. They will be the real power in the local NHS because they will hold the purse strings. Up until now, it has been unclear whether these consortia would be obliged to meet in public in the way PCTs do.

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NHS secrecy breakthrough: You shall go to Foundation Trust board meetings

I should have picked up on this sooner, but I’ve been rather distracted over the last week by the birth of my baby daughter.

Anyway, about three weeks ago I blogged on the potential threats to information access caused by the NHS reforms. The threats are three-fold:

1. The abolition of Primary Care Trusts – the bodies which decide how NHS money is spent locally – in favour of GP consortia. PCTs currently meet in public to take decisions, and there is no commitment that consortia will do the same. How, then, are those holding the purse strings to be held accountable?

2. The push for more Foundation Hospital Trusts: These are hospital trusts which have some freedoms from government rules and regulations. Sadly, one of those freedoms has, up until now, been the right to meet in private, rather than in public.

3. The closure of strategic health authorities: Not, in my opinion, necessarily a bad thing but it does remove one more way into NHS information as all PCTs and hospital trusts report to the SHA. In future, this sort of monitoring will be done by an organisation called Monitor. The level of monitoring, and how accountable it will be, remains unclear.

But Andrew Lansley, the health secretary, has delivered some good news on point 2, concerning founation hospital trusts. He is inserting a section into his Health and Social Care bill which will force  Foundation Trusts to hold their board meetings in public.

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NHS secrecy update: Some good news, but still a long way to go

I was quite surprised by the response to my post last week about the perils of the new NHS legislation for journalists. It seems to have caught the eye all over the place, so particular thanks to Roy Greenslade, Press Gazette and the Editor’s Weblog for linking to it and commenting on it.

I raised two main concerns: Firstly that the NHS reforms put an emphasis on creating more hospital foundation trusts. Currently, hospital trusts given foundation status are given the right to hold board meetings in private.

My second concern was the accountability of the GP consortia which will replaced primary care trusts in commissioning services. Currently, PCTs meet in public – there is no such provision for consortia to do the same at the moment.

Simply relying on the goodwill of health bosses to meet in public ‘because it’s a good thing to do’ isn’t enough – two thirds of existing foundation trusts meet in private – real evidence of the need to do enshrine the right of the press and public to attend board meetings in public.

Since last week, things have move on a bit, with revised NHS legislation due to be proposed today. Of interest to journalists will be the power of health and well-being boards, which are being set up by councils, being beefed up and patients given a greater role on them.

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Why journalists should be worried about the NHS reforms

Imagine there was a hospital trust in your area which employed 10,000 people – one of the top five employers in an area. It has a turnover of £265million, operated 1,200 beds across several large hospitals and was relied upon by over a million people in times of need.

Imagine, as a journalist, if you were told you couldn’t receive their monthly board meeting papers, and were told that the meetings themselves were being held in private. Why? Because the hospital trust in question has Foundation trust status.

The hospital trust I’m referring to above is Heartlands, which serves a large part of the West Midlands. It does publish minutes of the meetings online but hasn’t published an agenda ahead of the meeting since the turn of the year. Its website confirms that its monthly board meeting is held in private:

“The hospital management is led by the Board of Directors. They are responsible for all operational and strategic issues, business and finance and they meet once a month in private.”

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FOI officers hunting round-robin requests? Three ways to reduce that happening

An interesting post from the ever-good FOI Man today looking at the mountain of guidance communications staff in the NHS get hit with, including those dealing with FOIs.

It would appears FOI officers are expected to second-guess when an FOI request may be a ’round robin’ in the sense that it has been submitted to more than one body.

To quote the NHS Information Toolkit:

“Staff that manage FOI requests should be alert to the possibility that a request may have been sent to a number of organisations – ’round robin requests’ – and there should be a documented procedure for alerting Strategic Health Authority (SHA) FOI leads so that they can provide coordination and support. SHA FOI Leads should in turn alert the Department of Health.”

As FOI Man points out, how to spot a round robin email is anyone’s guess – but it certainly appears to conflict with the notion of all FOI requests being treated equally. The motives of an FOI requester shouldn’t be a consideration so why should the fact that the FOI may have gone to other authorities as well?

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