Friday Five

A bad week for cancer screening, a good week for advances in digital health – this week’s Friday Five

New NICE guidelines for digital tech

As the digital heath industry continues to grow and shows no signs of slowing down, its importance in the NHS sets to increase in the future. In response to this, NICE has published new standards setting out the requirements needed to develop digital health technologies for the NHS and speed up uptake of products like healthcare apps and wearable devices.

The standards address both clinical and economic impact and what evidence is needed to develop a case for use in the NHS. They have been developed to provide guidance on what evidence is needed when innovators present their products to NHS commissioners, supporting digital health technology development.

Currently evidence in the field of digital healthcare is sparse, due to the challenges faced in developing clinical trials. The evidence required for digital healthcare has also been defined in these guidelines, such that the amount required is measured against the risk of the new technology.

Dr Indra Joshi, clinical lead for NHS England’s digital experience programme said, “The NHS needs to be sure any new digital tools are backed by appropriate evidence and these new standards, developed in partnership with NHS bodies, industry and academia, will be the start of that dialogue of defining what “good” looks like in digital health technologies.”

Read more on PharmaPhorum.


New NHS England and Improvement directors announced

The new joint directors of NHS England and Improvement have been confirmed as three former hospital chief execs, an ex-department of Health Director general and three existing NHSE or I employees. The new roles are part of a significant overhaul of the national NHS bodies, which is expected to cut running costs by 20 per cent. The new regional directors will form part of a new “NHS executive group” which according to an NHSE and I statement “is set to hold its first meeting in January 2019, with the new national and regional directors expected to formally lead their integrated directorates by April 2019”.

The seven joint regional directors are:

  • South West – Elizabeth O’Mahony, currently NHSI’s chief financial officer.
  • South East – Anne Eden, already joint NHSE and I regional director for the South East.
  • Midlands – Dale Bywater, currently NHSI’s regional director for the Midlands and East.
  • East of England – Ann Radmore, currently Kingston Hospital Foundation Trust chief executive.
  • North West – Bill McCarthy, currently deputy vice chancellor at Bradford University and chair of Bradford Teaching Hospital Foundation Trust and a former NHS England and Department of Health executive director.
  • North East and Yorkshire – Richard Barker, currently NHSE’s director for the North of England.
  • London – Sir David Sloman, currently Royal Free London Foundation Trust.

Read more on HSJ.


Winter pressures are taking their toll

According to latest NHS figures hospitals are overcrowded and dangerously full, despite the weather being mild and the flu not being a major issue this year. Waiting time targets have been missed, including only 87.6% of patients arriving at A&E were treated within 4 hours, not the 95% that should be. 94.2% of hospital beds were occupied, a long way off the 85% figure that is stated as being the safe limit. A&E departments are having to divert patients to other hospitals and almost 55,000 patients spent at least four hours on a trolley before getting a bed

The Kings Fund chief analyst, Siva Anandaciva, said: “Hospital bed occupancy levels are already higher than recommended levels, the point at which hospitals are so full that good patient care is put at risk”.

Year on year the NHS faces unprecedented demand and it continues to grow. The number of patients being admitted as an emergency in November – 545,000 – was up 6.3% on the same month last year. Hospital departments are facing more pressure than ever, with funding cuts and staff shortages, more needs to be done to combat the strain and protect the quality of patient care.

Read more in the Guardian.


Cervical screening scandal

It has emerged that an additional 3,591 women have not received information about NHS cervical cancer screening and is estimated to have affected 40,000 women in England.

NHS England says there is no evidence of any harm having resulted from these issues, now dating back to 2017. 200 or more women who did not receive abnormal test results letters still had the correct clinical follow-up investigations despite the correspondence failure. Those that did not receive a letter have been written to and Capita, the company responsible for sending out the letters, has “apologised” for the mistake. The spokesman said the correct process for “uploading, organising and checking” had not been followed and appropriate disciplinary action was being taken.

Read more in the BBC.

Jeremy Hunt incorrect breast screening statement

In a statement made by the former Secretary of State for Health and Social Care, Jeremy Hunt, in May, stating that nearly 500,000 women had not been invited for breast cancer screening and that 270 may have died needlessly was based on wrong advice, an inquiry has found. Many women were alarmed following this statement, which subsequently led to the screening of all women aged 68 to 71 who were thought to have been missed.

Read more in the Guardian.


Quote of the week

“And it dawns on me that in searching for that elusive gift for an ageing parent, we are neglecting the one that is most obvious: the gift of our time” 

This week’s quote comes from oncologist, Ranjana Srivastava, who narrates through the age old dilemma of finding her father the perfect birthday present. However, after meeting an elderly man who was reluctant to take a break from the relentless chemotherapy because, in his words, “If I stop treatment, I may not see my son. He drives me to chemotherapy and takes me home – it’s our time together. It’s the nicest thing about having treatment.”, She reconsidered her dilemma. He saw the toxic chemotherapy as the price to pay to see his son. Loneliness among the elderly is a huge problem especially as Christmas edges closer and Ranjana stresses that the antidote to loneliness does not lie in a big gift but rather spending time with those that are closest.

Read Ranjana’s story here.