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38-702: In September 2023 Modality Mid Sussex was placed in Special Measures after a report by the CQC. The CQC committed to a reassessment in March 2024 which did not take place. Residents experience major problems with many trying to contact Modality for months yet not being able to get an appointment. The partnership was given a favourable mention in 2014 in the NHS Five Year Forward View . It already conducts 80% of consultations remotely using phone or Skype . Sarb Basi,

76-536: A block contract agreed between Blackpool Teaching Hospitals NHS Foundation Trust and the clinical commissioning groups in Blackpool, and Fylde and Wyre offered a "clear incentive" for GPs to refer patients to the foundation trust and that this was anti-competitive behaviour. The contract provided the trust with a guaranteed income regardless of the number of patients that chose to use its services. Monitor conducted an investigation and decided In September 2014 that there

114-589: A clinical background, which damages Monitor's credibility in dealing with trusts and its effectiveness in diagnosing problems and developing solutions". The PAC also criticised the proportion of Monitor's budget spent on external consultants (£9 million of Monitor's £48 million budget in 2013-14) and found that "some NHS foundation trusts had been allowed to struggle for far too long in breach of their regulatory conditions. It has taken Monitor too long to help trusts in difficulty to improve, with three trusts having been in breach of their regulatory conditions since 2009". At

152-577: A deficit of £2bn in 2015-16. In 2010 the Stafford Hospital scandal investigation recommended that Monitor de-authorise the Mid Staffordshire NHS Foundation Trust . In line with the investigation report recommendation, Secretary of State for Health , Andy Burnham , agreed to a further Independent Inquiry of the commissioning, supervisory and regulatory bodies for Foundation Trusts. Spire Healthcare alleged in 2013 that

190-483: A drive to improve the health of the nation. He pledged to get junk food out of hospital canteens. The plan also pays far more attention to the potential for technological innovation using the internet and mobile phone and apps than any previous NHS document. Technology, it envisages, will enable self-management, integration and patient centred care. This has already been done by the Modality Partnership which

228-581: A licence unless they are exempt under regulations made by the Department of Health. Foundation trusts were licensed from 1 April 2013, and all other non-exempt providers were required to apply for a licence from April 2014. It was announced in June 2015 that the chief executive posts at Monitor and the NHS Trust Development Authority were to be merged, although there would not be a complete merger of

266-515: A lot more mental health concerns. Five Year Forward View The Five Year Forward View was produced by NHS England in October 2014 under the leadership of Simon Stevens as a planning document. It received praise for brevity, being only 39 pages, and lacking the illustrations which had graced its predecessors. Like the NHS Plan 2000 with which Stevens was also associated it was supported by

304-453: A majority representation from former or seconded employees of KPMG, PWC and Deloitte while still awarding contracts to these organisations worth millions of pounds. In July 2013 six NHS foundation trusts were placed in special measures as a result of the Keogh Review of patient safety: Subsequent trusts placed in special measures: Enforcement action has been taken on 21 occasions in

342-455: A year in real terms will be required. No more top-down reorganisation was proposed, but instead the development of new models to suit local needs, something quite radical for the NHS, which is accustomed to the imposition of uniformity regardless of local conditions. It seeks to break away from Enoch Powell ’s 1962 Hospital Plan for England and Wales which established the district general hospital as

380-468: Is given a favourable mention in the document. It already conducts 75 per cent of consultations remotely using phone or Skype . Patients have an electronic care plan they can manage themselves, and digital access to consultant advice. According to Nick Timmins it is the first NHS document he could recall that said NHS structures did not have to be the same everywhere. This document, published in March 2017, outlined progress since 2015 and priorities for

418-633: The FutureNHS collaboration platform, built on the Kahootz collaboration software. An evaluation study of the platform estimated that it has saved the NHS £3.5 million within its first year in 2017. Integrated primary and acute care systems will bring together GPs, hospital, community and mental health services. Money will be directed from a joint budget to wherever patients are judged to need it most: Multispecialty community providers are supposed to bring specialist services, like chemotherapy and dialysis, out of

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456-656: The House of Commons health select committee in October 2014 that he envisaged in Birmingham two large groupings of GPs - the Vitality Partnership and another which would employ geriatricians. It is suggested that under Simon Stevens ' plan large primary care organisations like Modality could be in a position to challenge the dominance of NHS hospital trusts It has extended the primary care services to include urology, dermatology, rheumatology and x-rays. David Cameron cited

494-660: The Modality practices in September 2018. If this is successful it will be extended to all their 400,000 patients. It proposes to run the bank and back office services for new primary care networks in England which include its practices, and is already doing so in Walsall . It had the largest pay gap between male and female employees (60.7%) of 154 companies based in Birmingham in 2018/19. In July 2019 it announced it would have to close one of

532-818: The NHS and councils to work together to provide more healthcare in care homes, and to provide better preventive services there: Development of the NHS 111 is a central issue for most of these projects. It's intended that it should meet all urgent clinical needs rather than just be a signposting service so that appointments could be made directly with GPs or rapid access mental health services. A further wave of 8 new sites were announced in July 2015: In February 2016 NHS organisations in England, both Clinical Commissioning Groups and NHS trusts , were grouped into 44 footprints which were each required to produce joint plans with their local authorities for health and health service transformation for

570-639: The NHS could deliver £22bn of annual savings in 5 years’ time, is the latest of a long line of reports to assert that there is scope for the NHS to make major savings, but the report does make it clear that more resources, an extra £8bn in Government funding by 2020 would be needed. It claimed that there would be a "radical upgrade in prevention and public health", but as Dr Sarah Wollaston pointed out in October 2016 there were reductions in other areas of health spending outside NHS England’s budget, in particular public health. Without improvements in social care she said

608-492: The NHS could not be expected to deliver the Five Year Forward View. NHS efficiency savings of 2% to 3% a year from 2015 to 2021 were supposed to save £22 billion a year. Between 2004 and 2014 NHS output increased considerably. Hospital admissions increased by 32%, outpatient attendances by 17%, primary care consultations by 25% and community care activity by 14%. Hospital death rates reduced, especially in stroke. At

646-562: The brand name Monitor from August 2004 The Health and Social Care Act 2012 formally changed the organisation's name to Monitor and gave it additional duties. In addition to assessing NHS trusts for foundation trust status and ensuring that foundation trusts are well led, in terms of quality and finances, Monitor had a duty to: Monitor's main tool for carrying out these functions was the NHS provider licence, which contains obligations for providers of NHS services. The 2012 Act requires everyone who provides an NHS health care service to hold

684-559: The central pillar of British healthcare. Even more radical is the proposal to erode the distinction between hospital consultants and General practitioners, encouraging hospitals to employ GPs - a distinction which has lasted in the UK for more than a century - and permit the development of "Accountable Care Organisations" similar to those in Spain and parts of the United States. There is much stress on

722-430: The fact that 70% of the NHS budget is spent on the management of the 15 million people with long term conditions. Two new models of care – multispecialty community providers, and primary and acute care systems – involve integrating primary care and hospital care in a single provider organisation. The fact that the word “competition” does not appear once in the document was hailed as a victory by Labour. Stevens said that

760-399: The first 10 months of 2013/4, compared to just nine instances in the whole of 2012-13. Monitor's former chief executive David Bennett admitted the regulator's "arm's length" distance from foundation trusts had become "a little shorter" as it intervened more readily and that increased monitoring and intervention was explained by "a declined appetite for risk" among "Parliament, the government and

798-570: The five GP surgeries it runs in Hull because of staffing difficulties. After activity surged in the wake of the COVID-19 pandemic in England the group found that its GPs had an average of nearly 50 patient contacts per day - around double what the British Medical Association says is the “safety limit". Average time per consultation had risen from 12 minutes in 2020 to 15 minutes in 2021, with

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836-554: The great and good of the NHS, but in this case it was regulators - Monitor , the Care Quality Commission and the like, rather than the Royal Colleges and Trades Unions of the earlier plan. This new national leadership of the NHS issues an unprecedented warning to politicians, none of whom are included in the endorsements, that it cannot continue at current funding levels, and additional resources worth more than 1.5 per cent

874-586: The health service would have to break out of its “narrow confines” and promote healthy lifestyles. Employers are key to promoting better health in the population and there should be incentives to encourage participation in Weight Watchers-type schemes. The plan includes a focus on the health of NHS staff, saying that three quarters of hospitals fail to make available nutritious food for nurses and other workers on night shifts. Stevens said NHS staff should set an example by leading healthier lifestyles as part of

912-508: The hospital and closer to people’s homes. They were described as a "political vanity project" in April 2017 by Dr Tom Coffey , who is NHS England London clinical director of emergency care. NHS England announced three potential routes for MCP contracts in July 2016: By August 2017 some of these providers appeared to be merging into the proposed accountable care systems . Approved proposals: Models of enhanced health in care homes will enable

950-450: The managing director, said in response to the NHS Five Year Forward View that it would be a “natural, logical progression” to manage capitated budgets for health and social care budgets through an integrated care organisation, building a "coherent strategic partnership" with an acute hospital and working with community health trusts to incorporate nursing and therapy services. This appeared to connect with comments made by Simon Stevens to

988-464: The next two years. Containing the growth in A&;E admissions and bed days is to be a priority. GP practices are to be organised into area hubs covering populations of up to 50,000. At least 150 new inpatient beds for children and young people with mental health problems are to be provided. There will be reforms to increase the number of nurses and reforms to enable more flexible working. Its claims that

1026-506: The organisation had yet to identify a strategy to counter those opposed to competition because it clashed with their personal ideologies. He claimed organisations were using competition regulations as an "easy excuse" for avoiding making necessary changes. In October 2014 after the publication of NHS England 's 'Five year forward view' Bennett defended Choice and competition as "one of the ways in which we can drive change and improvement for patients, and we don't see that that will cease to be

1064-634: The organisations. In April 2016 both organisations became part of NHS Improvement which subsequently operationally merged with NHS England from September 2018 and was formally abolished by the Health and Care Act 2022 . In July 2014, Monitor was criticised by the Public Accounts Committee of the House of Commons (PAC) for the lack of clinical expertise and frontline NHS experience amongst its staff. The PAC noted that: "Only 21 of Monitor's 337 staff have an NHS operational background and only 7 have

1102-549: The partnership in May 2015 when he praised Birmingham's transformation of primary care. It signed an agreement with Sandwell and West Birmingham Hospitals NHS Trust in November 2017 which was a “commitment to work collaboratively over the next three to five years with a view to forming a much more vertically integrated relationship”. Nick Harding, one of the co-founders, and chair of Sandwell and West Birmingham Clinical Commissioning Group

1140-557: The period up to 2020. Each had a leader, some from the NHS and some from local authorities. See Sustainability and transformation plan . Monitor (NHS) Monitor was an executive non-departmental public body of the Department of Health , responsible between 2004 and 2016 for ensuring healthcare provision in NHS England was financially effective. It was the sector regulator for health services in England. Its chief executive

1178-483: The public". Details of the regulatory action Monitor has taken at NHS foundation trusts are available on its website: http://www.monitor.gov.uk/about-your-local-nhs-foundation-trust/regulatory-action/nhs-foundation-trusts-special-measures-or-un . In August 2015 Monitor issued a letter to all Foundation Trusts telling them to fill vacancies "only where essential" and warning that current financial plans are "quite simply unaffordable" as NHS providers collectively forecast

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1216-433: The rest of England 1.3%. Both MCPs and PACS saw substantially slower growth in the rate of emergency admissions per 1,000 population than the rest of England. Growth for MCPs was 2.6% and for PACS the figure was 1.2%. In the rest of England it was 4.9%. In order to ensure the knowledge from the new models of care was captured and shared throughout the health and care system, the national new care models programme established

1254-498: The same time there was an increase in wages of 24% and an increase of 10% in the number of staff and increases in the use of equipment and supplies. As a whole NHS output increased by 47% and inputs by 31%, an increase in productivity of 12.86% during the period, or 1.37% per year, considerably less than envisaged in the Five Year Forward View. 29 areas were selected (from 269 applicants) to pilot new models for localised healthcare in March 2015. When insufficient transformation funding

1292-549: The time of the PAC's hearing, of 147 foundation trusts 39(26%) were expected to be in deficit by the end of 2013-14 and on 31 December 2013 25 (17%) were in breach of the conditions attached to their status. The PAC also noted: "It is wholly inappropriate that the same person acted as both Chair and Chief Executive of Monitor between March 2011 and January 2014. This was contrary to corporate governance good practice and Monitor's own guidance to NHS foundation trusts". The board of MONITOR has

1330-469: Was Ian Dalton and it was chaired by Dido Harding . Monitor was merged with the NHS Trust Development Authority to form NHS Improvement on 1 April 2016. The body was established on 5 January 2004 under the Health and Social Care (Community Health and Standards) Act 2003 , and was formally called The Independent Regulator for Foundation Trusts. The legislation made it responsible for authorising, monitoring and regulating NHS foundation trusts . It took on

1368-484: Was allocated in September 2016 the plans were scaled down. Proposals for companies to run primary and acute care systems or multispecialty community providers appear to have been prevented because they would be liable for VAT . In the 12 months to September 2017, compared to the 2014–15 financial year, there was a reduction in the rate of hospital bed days per 1,000 population - for Primary and acute care systems 0.5%, for Multispecialty community providers 1.5%, and for

1406-444: Was no evidence to support the claim though they did conclude that Blackpool CCG's plans did not "go far enough" to ensure patients would be offered choice, or that the right to choice would be "publicised and promoted". Blackpool CCG complained that not a single GP, practice manager or patient was spoken to by the investigating team, nor was a single practice visited. In September 2014 former chief executive David Bennett admitted that

1444-864: Was reckoned by the Health Service Journal to be the 47th most influential person in the English NHS in 2015. In April 2017 it took over four more GP practices in Hull, with 48,000 patients, bringing its total list to 150,000. In June 2017 it took on Wokingham Medical Centre, its 27th practice, with 20,000 patients. In September 2017 it took over six GP practices in Airedale , Wharfedale and Craven , bringing its list to more than 200,000 patients. It took over three practices based in Lewisham in July 2018. The partnership started to offer online consultations using Push Doctor to more than 99,000 patients across six of

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