This week our stories focus on the related topics of data, targets and budgets. The government is planning to cut NHS England’s managerial budget, and giving more power to hospitals to make their own decisions. It also intends to scrap a review of A&E waiting targets, preferring to stick to existing ones. New data on GP appointments will reveal which practices see a high proportion of patients remotely rather than face-to-face.
The government is planning to cut the budget for NHS England’s managerial and admin staff by as much as half, in order to free hospitals to decide how best to meet the needs of patients.
An NHS review commissioned by chancellor Jeremy Hunt and health secretary Steve Barclay is to be tasked with finding ways of giving hospitals greater autonomy and reducing “Stalinist” national targets. Hospitals will also be required to have greater accountability for how they perform and what they spend.
The aim is to make sure that the extra £3.3 billion pledged for the NHS in the autumn statement is spent on frontline services rather than on administration and management.
A small pilot in which patients whose health conditions worsen in the cold are prescribed heating has been so successful that it is being expanded to 1,150 homes.
The Warm Home Prescription pilot paid to heat the homes of 28 low-income patients to prevent them from becoming more ill and having to go to hospital. One participant, Michelle Davis, who has arthritis and pulmonary illness, told the BBC that the difference was “mind-blowing”.
Researchers have estimated that 10,000 people die every year as the result of living in a cold home, and that cold homes cost NHS England £860m a year – figures that might rise as the result of the current cost-of-living crisis.
The pilot’s achievement in keeping people out of hospital means it will now be rolled out to 150 households in the NHS Gloucestershire’s area, and about 1,000 in Aberdeen and Teesside.
Government ministers have rejected NHS England’s planned A&E targets, preferring trusts to be firmly regulated on the existing targets, according to HSJ.
The two existing targets require 95% of A&E patients to be seen within four hours, and 100% to be seen within 12 hours. NHS England has lobbied government to remove the four-hour target and replace it with other measures that have been piloted at a dozen providers.
The decision to continue using the four-hour target has been driven by concerns among ministers and senior NHS figures that the new measures were too confusing, both for patients and as a means for government to hold the NHS to account.
Four out of five trusts in England have not reached the level of digitisation required by 2025.
NHS England told technology suppliers last week that its “best estimate” showed only of trusts had met its “minimum digital foundations” necessary to achieve the “core level of digitisation” set out in the 2019 NHS Long-Term Plan.
The long-term plan stated the core level of digitisation should cover clinical and operational processes across “all settings, locations and departments” based on “robust, modern IT infrastructure services for hosting, storage, networks and cyber security”. It initially committed trusts to achieving the digitisation target by 2024, but this was later moved to the end of the 2024-25 financial year.
Speaking at a webinar hosted by Tech UK, Paul Gilliatt of NHS England said that 160 trusts were still to meet digital maturity.
A beta version of the new NHS Wales App is being piloted 1,000 people in 10 GP practices.
The aim of the pilot is to test the functionality and features in the app, ahead of a wider public launch next year. Digital Health Care Wales hopes this phase will enable it to identify any issues and bugs in the software.
Once rolled out fully, the NHS Wales App will provide people with access to health and care services through their smartphone, as well as the ability to book appointments, see test results and order prescriptions.
The long-term aim for the app is to enable people in Wales to access a wide range of health, care and wellbeing services, potentially including social care services, information from self-monitoring devices such as smartwatches, and data held by third sector organisations.
The NHS is to publish data on every GP surgery in England, showing how long people have to wait for an appointment and the proportion of appointments that take place in person, rather than on the phone or over video. There is wide variation between practices, and the data will identify surgeries where the majority of appointments are remote.
At a national level, approximately two-thirds of appointments take place in person, compared with 80% before the pandemic.
While Steve Barclay, the health secretary, hopes that the data will enable patients to make more informed choices, GPs are concerned that it will create league tables of GP practices, without taking into account the reasons some appear to perform worse than others.