Client zone

GPs rally patients against cuts which would see up to 100 practices close

GPs are mobilising patients to campaign against planned cuts to funding which threaten to close 100 practices in England, with doctors in east London taking the unprecedented step of blanket texting patients to raise support.

Practice managers estimate that up to 700,000 patients in England could lose their local GP surgery if controversial Government plans to reallocate millions of pounds worth of GP funding go ahead.

Although aimed at making GP funding fairer, the withdrawal of the minimum practice income guarantee (MPIG) could leave 98 practices facing funding cuts that will put them at risk of closure.

NHS England pledged earlier this year that the 98 would be offered support, but local GPs and the British Medical Association (BMA) have both attacked health chiefs for failing to put any concrete plans in place to rescue surgeries at risk.

The reorganisation has disproportionately impacted practices in inner city areas with high levels of deprivation, as well as rural surgeries with small numbers of patients who have to travel miles to see their doctor.

The changes come amid wider discontent in the profession over the falling share of NHS funding set aside for GP services.



The high-performing Jubilee Street Practice in Tower Hamlets, which stands to lose £1 million of MPIG funding over the next seven years, recently texted all patients to alert them to the risk that the surgery might close.

Meanwhile the Nightingale Practice in neighbouring Hackney has texted all patients to ask them to sign an online petition against the withdrawal of MPIG funding.

Only patients who had consented to receive text messages from their surgery received the messages, and no additional network costs were incurred, spokespeople for both practices said.

NHS England maintains that the majority of GP practices stand to gain from the reallocation of MPIG funds, but said it would work with practices that will lose out.

Their chief executive, Simon Stevens, England’s top health official, has been personally warned about the risk of practice closures by the BMA’s GP chair Dr Chaand Nagpaul, who has requested an urgent meeting on the issue.

NHS England is expected to set out its plans for surgeries at risk in London by the end of this week. However, with NHS budgets already severely stretched, any extra funding to support GP services at risk may have to come from the Government and pressure is growing for the Health Secretary Jeremy Hunt to intervene.

Labour’s shadow Health Secretary Andy Burnham said that the changes were “pull[ing] the rug from under a number of very valuable practices” at a time when people were already finding it harder to get a GP appointment.

“Jeremy Hunt must grasp the nettle and sort out this threat of GP practice closures,” he said.

Representatives from the Jubilee Street practice will meet the Conservative health minister Earl Howe next week in an attempt to reach a breakthrough.

Dr Sarah Williams, a GP at the Nightingale Practice, who set up the petition on the campaign website 38 Degrees, said that patients needed to be warned about the scale of the threat to services.

“If we don’t get publicity and start shouting about it then it will just get pushed through quietly and it will be too late,” she said. “We need to mobilise patients. There are so many people who don’t want to see their surgery close.”

The Royal College of General Practitioners backed the petition, repeating calls for the Government to guarantee that no practices would close as a result of the withdrawal of MPIG funding.

RCGP chair Dr Maureen Baker told The Independent: “We are clear that this is another unnecessary, yet very concerning, pressure for GPs to deal with and unfortunately it is patients that will suffer most.”

An NHS England spokesperson for the London region said: “We understand the challenges some London GPs are facing as a result of these changes…These changes – which are part of a national policy – will help make GP funding more equitable across London and the majority of practices will gain as a result.”

A Department of Health spokesperson said that NHS will be “supporting the most affected practices to adjust” as MPIG payments are phased out.


UK women are fattest in western Europe: 1 in 12 are clinically obese

Young women in the UK are fatter than anywhere else in western Europe with one in 12 being clinically obese, a study has shown.


Researchers looking at weight levels in 188 countries found that more than half the planet’s 671 million obese people live in just 10 countries.

Just over eight per cent of females in the UK aged under 20 are obese while 29.2 per cent are overweight, according to research published in The Lancet medical journal.

The study, which uncovered a “startling” surge in the level of obesity worldwide, found in the UK that among adults, those aged 20 and older, a quarter are obese.

More men are fat than women with 66.6 per cent classed as overweight and 24.5 per cent obese. Among women, 57.2 per cent are overweight with 25.4 per cent classified as obese.

Professor John Newton, of Public Health England, said: “The levels of obesity in the UK – and indeed, across the world – are of great concern. That is why Public Health England is putting in so much effort to attempt to reverse the trend.

“The challenge of obesity is at the heart of current debate about the health of the nation and we are working closely with local authorities, the NHS and the voluntary and community sector to tackle this complex issue.”

Researchers discovered that worldwide from 1980 to 2013 the number of overweight people rose from 857 million to 2.1 billion, an increase of 28% for adults and 47% among children.

The ten countries which are home to more than half the world’s obese people are the US, which has 13 per cent of them and where a third of adults are obese, China, India, Russia, Brazil, Mexico, Egypt, Germany, Pakistan and Indonesia.

Of 22 western European countries looked at by the research team, Andora performed the best. Of its population of just over 78,000, 10.6% of adult men and 7.2% of women are classified as obese.

Professor Emmanuela Gakidou, from the University of Washington, led the study and said: “Unlike other major global health risks, such as tobacco and childhood nutrition, obesity is not decreasing worldwide.

“Our findings show that increases in the prevalence of obesity have been substantial, widespread, and have arisen over a short time. However, there is some evidence of a plateau in adult obesity rates that provides some hope that the epidemic might have peaked in some developed countries and that populations in other countries might not reach the very high rates of more than 40% reported in some developing countries.

“Our analysis suggests that the UN’s target to stop the rise in obesity by 2025 is very ambitious and is unlikely to be achieved without concerted action and further research to assess the effect of population-wide interventions, and how to effectively translate that knowledge into national obesity control programmes.

“In particular, urgent global leadership is needed to help low-and middle-income countries intervene to reduce excessive calorie intake, physical inactivity, and active promotion of food consumption by industry.”

Play it Up: Scheduling’s Role in Improving Private Duty Care

Doing more with less has become something of a mantra in healthcare. For those involved with private duty nursing, doing more with less is just the tip of the iceberg, say Shallina Bowers, executive director, HealthCare Services, and Wes McGuirk, regional director, at Oxford HealthCare, Springfield, Mo.

Schedulings-role-in-private-duty-care-300x200Bowers and McGuirk led a session during the 2014 McKesson Homecare & Hospice National Users’ Conference on how to help drive business through effective private duty scheduling.

Two main factors are driving change for private duty organizations: client expectations and increasingly complex scheduling. Our aging population (a 135% increase in adults aged 75 or older from 1950 to 2050, according to the Census Bureau) means private duty services are in demand and likely to become more so.

But it’s not our mother’s private duty — today’s providers face increased requirements and a more sophisticated client profile. And instead of the 48-hours-per-week average private-duty contract Oxford HealthCare saw in 2005, today’s patient wants around 16 hours per week, making scheduling a critical function for providers.

Fortunately, advanced home care scheduling software can expedite today’s private-duty administration, helping to improve customer service, eliminate scheduling errors and streamline the billing process. It’s also a terrific way to help differentiate your offering from your competitors.

Before and after
In the past, private duty involved:

  • Mainly private-pay patients
  • Few regulatory requirements
  • Mainly nursing functions

In contrast, today’s private duty often involves:

  • Multiple payers for the same visit
  • Requirements that vary by payer
  • Varied services (everything from babysitting and housekeeping to personal care aide services and nursing services)

Keeping track of scheduling, billing and payroll in this constantly changing landscape can be a daunting task. Not to mention clients who expect to receive precisely the service they contracted for (and don’t want to track what was provided when) and employees who need immediate notification of schedule changes and want control over where and when they work.

Clearly, today’s private-duty managers need all the help they can get. Bowers and McGuirk say they need sophisticated features like those in the home care scheduling functionality of McKesson Homecare™:

  • Incentives promised to the employee can be built directly onto the schedule
  • Notes for employee performance can be documented and used at evaluation meetings
  • Single visits involving multiple payers can be built on the same episode
  • Education can be built directly into employee schedules so they don’t miss it
  • Education can be assigned, completed and tracked from within the system
  • Sharing of employees across business lines can be simplified
  • Nurse care managers can easily see which tasks still need to be performed and quickly change patient care plans as needed

A game changer
Solving your home care scheduling issues does more than just help you gain efficiencies — it gives you a way to set your agency above the competition. Instead of tired marketing campaigns touting “compassionate care” and “leadership in the industry,” you can talk about real benefits.

For example, Bowers and McGuirk say that better scheduling and tracking means patients don’t have to worry about policing their private-duty appointments. Instead, they’ll see high service levels, prompt visits, staff changes kept to a minimum for better continuity of care, and a seamless process with no scheduling errors or billing issues.

You’ve got a great story to tell employees as well, including having the information they need at their fingertips and a work schedule that reflects their preferences for geographic areas and times of the day. They’ll also be able to easily understand their paycheck so they can match it with their records.

Bowers and McGuirk say that you’ll soon be going beyond doing more with less. You’ll be successfully doing better with less and creating satisfied clients along the way.

Cynics may be at greater risk of developing dementia

Older people who harbour a cynical distrust of others are about three times more likely to develop dementia than individuals who have a more trusting view of humanity, a study has found.


Cynical distrust was measured by questionnaires testing a person’s tendency to believe that others are mainly motivated by selfish concerns and it has in the past been linked with an increased risk of heart disease, the researchers said.

The findings suggest that a person’s psychological makeup could play a role in determining their predisposition to senile dementia, along with factors such as smoking, high cholesterol and cardiovascular disease.

“These results add to the evidence that people’s view of life and personality may have an impact on their health. Understanding how a personality trait like cynicism affects risk for dementia might provide us with important insights on how to reduce risks for dementia,” said Anna-Maija Tolppanen of the University of Eastern Finland in Kuopio, who led the research.

The study involved health and psychological tests on nearly 1,500 elderly Finns with an average age of 71 who were followed up over a period of about eight years to determine their general health and their views on life, such as whether they have high or low levels of cynical distrust of others.

For instance they were asked about whether they agree with statements such as: “I think most people would like to get ahead”, “it is safer to trust nobody, and “most people will use somewhat unfair reasons to gain profit or an advantage rather than lose it”.

During that time, 46 of a panel of 622 people who completed the two sets of tests at the start and end of the study had developed dementia. After adjusting for other factors known to affect dementia risk, such as smoking, the researchers found that of the remaining 164 people with high levels of cynical distrust, 14 had developed dementia, compared to nine among the 212 people judged to have low levels of cynicism.

“The main message from the study would be that psychological factors are also important for the risk of developing dementia,” said Alina Solomon of the University of Eastern Finland, one of the authors of the study published in the journal Neurology.

“It’s difficult to say what the exact reasons are but we could assume that an attitude of distrust may influence a person’s lifestyle and social networks… We don’t say it’s a causal factor, we just say it increases the risk,” Dr Solomon said.

Mobile health monitoring to be $8B market in 2019

The market for mobile health monitoring and diagnostics was worth $650 million in 2012, according to a new report from Transparency Market Research. The firm projects that the market will grow at a compound annual growth rate of 43.3 percent from 2013 to 2019. That will put the market at $8 billion in 2019.



Transparency defines the mobile health monitoring and diagnostic space as sm