Quality the medicine for NHS health improvement

July 28, 2010 – 10:40 AM

An astonishing story in this week’s news starkly illustrates the value of quality approaches, and the implications of the failure to implement them, more than any I have seen in recent times.

Against the backdrop of huge spending cuts in the public sector, a survey of NHS health trusts has revealed that the NHS is missing out on millions of pounds for the reimbursement of cancer drugs because of onerous paperwork.

Schemes for the NHS to share the cost of expensive new drugs with pharmaceutical companies have become increasingly common but a survey of 31 English health trusts published this week revealed that up to 50% of the costs had not been recovered due to the bureaucratic complexity of the process.

One consultant pharmacist demonstrated the system’s failure most succinctly by welcoming the wider access to new cancer drugs but adding that the reimbursement procedures were so onerous as to make the whole scheme unworkable.

Although benefitting from budget ring-fencing for the moment at least, the NHS, like all other parts of the public sector, is coming under pressure to both innovate and save costs so what does this say about its ability to do both?

When questioned about how the system could be devised to work better, users say that only relatively small changes need to be made, citing the need for form templates and greater flexibility on timescales. Yet, because process users presumably weren’t consulted about the process in the first place, the future of this ground-breaking government and private sector partnership is being threatened.

As the survey author says, the implications are enormous, not only in terms of potentially unclaimed assets for the NHS but the misuse of staff time and the threat to the future access of patients to the best drugs on the market. 

In response to the survey, a Department of Health spokesman said it continued to work with the pharmaceutical industry to make the schemes as easy as possible to implement but put the onus back on the primary care trusts to make individual arrangements on how to deal with the issue of reimbursement.

The difference between those that will succeed and those that will fail will of course be down to their willingness and ability to deploy basic quality management approaches and techniques such as those identified in Deming’s PDSA. It will be interesting to see how many of them can rise to the quality challenge.

Simon Feary
Chief Executive Officer

28 July 2010

By leader | Posted in Deming, Public sector | Comments (0)

Watching the green world go by

July 21, 2010 – 11:29 AM

It seems that the government’s promise of investment in the development of green technology has all been hot air. In the race to secure the future of a green technology industry, the UK could now be on track to lose.

Both the coalition and the previous administration had committed to huge expenditure in the area of green technology to deliver a high value economy and create thousands of highly skilled ‘quality’ jobs. Recent days however have witnessed a certain amount of backtracking on the vision to put the UK at the forefront of a green industrial revolution.

Now Cameron is launching his vision of the “Big Society”, funding for the Green Investment Bank that environment bodies were preparing to welcome now looks to have been diverted to other schemes. The latest news is that the Sustainable Development Commission is going to be axed.

The UK’s current funding levels for green technology at £550m per year are far below those of other developed economies and nowhere near high enough to keep up with others’ development.

And it’s not just developed countries that threaten to overtake us in this area. According to Tim Yeo, chairman of the commons energy and climate change select committee, China is investing “furiously” in low carbon technology and could be the economy best placed to profit from carbon reduction targets.

Even in the context of unprecedented public sector cuts, the UK is potentially missing a huge trick here. Green technology is a relatively new industry with enormous growth potential and we may be passing up the opportunity to cash in. And government, as well as industry investment, is key.

A recent report from the Committee on Climate Change predicts that without government support, green technology development could fall into the “valley of death” and never reach the market. So business, which is also facing difficult times, requires greater certainty to invest itself. This impasse endangers our longer-term economic recovery.

But economy aside, cutting our investment in green technology will, as the Committee on Climate Change maintains, also be a disaster for our target to cut greenhouse gas emissions by 80% over the next 40 years. Business has a significant role in this process and it is quality professionals who will work to reduce the environmental impact of their organisations and make them truly sustainable in both senses of the word.

After all, what sort of a “Big Society” will we have in the future if we don’t protect our environment?

By Simon Feary, CQI CEO

21 July 2010

By Sarah-Jayne | Posted in Uncategorized | Comments (0)

We are what we eat, so why endanger food standards?

July 14, 2010 – 10:19 AM

Nothing is safe from the eagle eye of government cuts and taking centre stage this week is the Food Standards Agency. Although the Department of Health is yet to announce whether the rumours are true, we may soon be living in a country with no single entity maintaining the standards of what we eat.

Cutting a body such as the Food Standards Agency does not have to be a catastrophe for the UK, as long as its safeguarding role is preserved and a viable alternative is presented. Saving money is something that we are all striving to achieve, and while it may be that some organisations need to be axed, this should not be to the detriment of the public’s welfare.

It is suggested that the FSA will be split into two: the regulatory aspects will fall under the Department for Environment, Food and Rural Affairs and the nutrition and public health aspects will fall under the Department of Health. This seems to be counter productive – by dividing an adequate organisation in two, aspects of food quality will fall between. Food safety and healthy food are two parts of the same orange and, given that obesity is a growing global concern, the two are inextricably linked.

Health groups are claiming that the health secretary is bowing to pressure from big businesses, allowing them a more permissive environment to sell food that is considered unhealthy and bad for the nation. Whether this is the case or not, standards will certainly be harder to maintain without a single body working to maintain our health.

The FSA was established in 2000 after a series of food scares and deaths from food-borne illnesses throughout the UK, such as the BSE crisis. Since then it has achieved a number of successes, including improved food labelling on processed food and, according to Defra, public trust in food safety has risen significantly. Also, in 2007 there were an estimated 23% fewer cases of salmonella than in 2000.

Compare this to the US where the approach to food quality is more fragmented. Food safety scares are much more commonly in the news, from salmonella in tomatoes to E.coli in bison meat. According to a poll by Deloitte Consulting, 76% of Americans are more concerned about food safety than five years ago.

Given these statistics, should we really be axing a department that has made a lot of headway? To be convinced that scrapping the FSA is a good idea and that the UK can continue to maintain its high standards of food quality, we need to be presented with a clear rationale and an alternative that will work.

By Simon Feary, CQI CEO

14 July 2010

By Sarah-Jayne | Posted in Uncategorized | Comments (1)

The safety net between life and death

July 8, 2010 – 2:26 PM

David Cameron has again brought health and safety to the public’s attention with the launch of a review into UK legislation. In his opinion, the current system is full of “joke” regulations and has given rise to a “compensation culture”. Meanwhile Lord Young, who is leading the legislative review, has described the health and safety culture in the UK as “a music hall joke”.

But these quotes only give weight to the misconceived public opinion that health and safety measures are something to be laughed at. By playing down the vital work of health and safety professionals in this way, we are in serious danger of trivialising the practice of preventing hundreds of deaths each year.

In the past three decades the number of workplace deaths in the UK has fallen dramatically. In 1974, 651 fatalities were reported but in 2009, after 30-plus years of the Health and Safety at Work Act, this number had dropped to 180. This is still a huge number of lives to lose, but without the sterling work of those that set the standards for health and safety, many more would have been lost.

Another aspect of health and safety that is often breezed over is the “health” part. While statistics focus on the number of deaths in the workplace, this accounts for only about four or five per cent of deaths caused by work. The rest are testimony to our failure to look after the health of our employees over the longer term. In a world where stress levels are increasingly high, surely we shouldn’t be making a joke of so-called “elf and safety”, but taking the matter seriously and doing all we can to protect people going about their job?

And if we look at this from a productivity viewpoint, there is an equally strong argument. According to the Health and Safety Executive, last year 29.3 million working days were lost due to work-related ill health and injury. Apart from the human cost, this is not something that the UK is in a position to laugh at given the current state of the economy.

There are certainly many examples of health and safety legislation being ”over interpreted”, but we just might be forgetting the countless times that health and safety measures have made the all-important difference between life and death.

By Simon Feary, CQI CEO

8 July 2010

By Sarah-Jayne | Posted in Uncategorized | Comments (4)