Croydon strikes again

Low clinical priority procedures (aka those that appear on the Croydon list) returned to the top of the pile briefly at the end of last year as the Right Care elective surgery project released its phase 1 report. The programme was prompted by an earlier Audit Commission study on reducing spending on low clinical priority procedures. The government took to heart the recommendation that national guidance be developed. However, critics (amongst which was the Federation of Surgical Specialty Associations - FSSA) have argued that the evidence base for this kind of decision-making is poor and that it doesn't sit at all well with the patient choice agenda. Hence the Right Care project, which involved the FSSA. Initial themes from the project include guarded support for national guidance, the suggestion that, since the current terms of art are unhelpful, "there should be a change in terminology to reflect a more holistic approach" and that blanket bans and resultant postcode lotteries should be avoided. A briefing from solicitors Mills and Reeve looks at the legal issues behind decisions about restricting access to low priority procedures.

Futurology

The rallying cry to "make every contact count" has formed the headlines about the NHS Future Forum's latest offering. However, it's by no means the only thing the Forum has to say. The other areas attended to are integration, information and education and training. Regarding information (as leaked just before Christmas), there's a stress on effective data sharing and interoperability rather than a national system, along with more explicit support systems to facilitate the roll-out of full patient access to health records by 2015 and a back-to-basics proposal of universal use of the NHS number at the point of data capture (again!). The proposals about integration focus on the principle of "integration around the patient" and the role of electronic accessible care records and patient reported experience measures. Along with the Future Forum's report on education, there is also a paper out from DH on the subject.

Patients, consumers or guinea pigs?

The need for effective public engagement is never more pressing than in this chilly economic climate, argues thinktank Involve. The NHS Confederation offers some advice to CCGs on how to make this work in the new commissioning landscape. Pressure Group the Patients Association has also done some research on the matter and amongst its concerns is how to reward and support patient representatives in CCGs. Elsewhere, the announcement that the government wants to foster innovation by releasing NHS patient data to researchers has not played brilliantly. Some have pointed out that the proposal to make every NHS patient "a research patient" does not sit particularly well with the patient empowerment agenda.

You say you want a revolution

The NHS information revolution was the focus of a conference hosted by the King's Fund recently. You can catch up with some of the presentations online, via the King's Fund webpages. Highlights include a paper on meeting the information needs of Clinical Commissioning Groups (CCGs) and another on the relationship between information, patients and choice, as well as a keynote address from Sir Muir Gray on what he is pleased to call the third healthcare revolution of knowledge, information and value. Also at the conference Giles Wilmore, Director of Quality Framework and QUIPP Programmes at DH, announced that publication of DH's new information strategy could not be expected before next spring (a second deferral for the unveiling of these plans). The Health Service Ombudsman's rather critical report on complaints handling in the NHS includes a plea for the information revolution to spread to information about complaints.