Diabetes care in England is “depressingly poor”, with 24,000 preventable deaths from the disease each year, according to the Public Accounts Committee.

The report from the parliamentary group follows similar critical studies by the National Audit Office and Diabetes UK, emphasising the variations in access to checks for risk factors and complications.

However, the Department of Health denied the report’s validity and asserted that the new CCG commissioning regime would ensure better-integrated services.

Margaret Hodge, chairwoman of the committee, commented: “There is no strong leadership and no effective accountability. Variation in the level of progress across the NHS also means that there is an unacceptable ‘postcode lottery’ of care.”

Echoing her own previous comments, Barbara Young, Chief Executive of Diabetes UK, said: "Given all the increasingly strong evidence of inadequate care, we simply cannot understand why the NHS has sleep walked into this situation."

However, a DH spokesman said recent improvements in access to checks for people with diabetes meant the report’s conclusions were false – but the variations in access to tests across England needed to be addressed.

In addition, he said, giving control of commissioning budgets to CCGs would ensure that more diabetes checks were carried out.

Private health provider Serco has admitted 252 instances of falsifying records of its out-of-hours GP service in Cornwall.

According to NHS Cornwall PCT, Serco failed in key responsibilities including clinical assessment of urgent calls and rapid response to emergency calls.

Former Conservative Health Secretary Stephen Dorrell commented: “To falsify returns once is once too many – to falsify 252 times represents a pattern of behaviour which should lead to a full review.”

Dorrell also noted that the case raised issues about the oversight of NHS service contracts, and these wider concerns made a full review essential.

The CQC reported that according to Serco staff ‘whistleblowers’, there was a culture of data manipulation within the franchise going back four years.

The PCT’s request for an audit of Serco’s records as provider of the service led to disclosure of the 252 alterations.

Labour MP Margaret Hodge has referred the case to the National Audit Office, commenting: “If there is any fraud it brings into question whether the company is fit and proper to provide public services.”

Serco has been accused of systematically understaffing its out-of-hours GP service, with medically unqualified staff used to ‘filter’ calls and GPs diverted from home visits at short notice.

The 252 changes to records appear to represent an attempted cover-up of violations of the company’s service contract terms.

The PCT noted that Serco had failed to meet three key targets: passing calls involving immediate risk of death to the ambulance service within three minutes; clinical assessment of urgent calls; and rapid access to the service by phone.

Paul Fordern, Managing Director of Serco’s healthcare business, said: “We apologise that this has happened. We are not in any way complacent and we recognise that we have a number of improvements to implement.”

The Care Quality Commission has experienced “serious difficulties” in its first 18 months, according to a National Audit Office report.

The NAO said the regulator had “struggled” to fulfil its role due to NHS instability, making only half of the hospital inspections it had planned.

However the CQC was “now taking action to improve its performance”, the report concluded.

The new inspection body replaced the Healthcare Commission, the Commission for Social Care Inspection and the Mental Health Act Commission in October 2010.

The NAO noted that the abrupt shift had caused “disruption for providers and confusion for the public”.

By April 2011 the CQC had carried out only 53% of its planned inspections of hospitals and care homes, and had not met its schedule for registering care providers.

The organisation suffered from lack of staff, the review said: after a year, 14% of its positions – including 100 inspector posts – were unfilled due to Government restrictions on recruitment.

Its failure to identify patient mistreatment and neglect at a residential care home near Bristol was also criticised.

Both the DH and the CQC itself were to blame for the regulator’s failings, the NAO concluded.

Amyas Morse, head of the NAO, commented: “The CQC has had an uphill struggle to carry out its work effectively and has experienced serious difficulties. It is welcome that it is now taking action to improve its performance.

He added: “The commission and the Department of Health should make clear what successful regulation of this critical sector would look like.”

The DH is currently reviewing the CQC; its findings will be published later this year. Margaret Hodge, Chair of the House of Commons Public Accounts Committee, called the NAO’s report “deeply worrying”.

Over 80 NHS trusts are struggling financially to convert to Foundation Trust status by the Government’s 2014 deadline, according to a new report from the Committee of Public Accounts.

The Committee also noted that 20 of these trusts – half of them in London – have declared themselves unable to make the transition.

NHS trusts that cannot convert by the deadline will be forced to lose departments and undergo mergers, and the report notes that in these cases “it seems inevitable that patients will suffer”.

The report calls for urgent consultation to find solutions to the financial crisis affecting acute care services, particularly in the capital, in order to avoid the widening of health inequalities.

According to the Department of Health, failing hospitals will be privatised rather than closed down – but as the report says, “some trusts are in such a poor financial state it is difficult to see why other organisations would want to take them on”.

Underlying problems identified include: a lack of clear leadership within NHS trusts resulting from the current “prolonged uncertainty”; a false reliance on “efficiency savings” to deal with major funding problems; and the crippling burden of PFI debts.

The Committee stated that “solutions should not reduce access to services for vulnerable people” – which it sees as a likely outcome of the forced reconfiguration of services in areas of social deprivation.

Margaret Hodge, Chair of the Committee, said: “London is in a particularly shocking state and nobody has got a grip on long-standing problems. We remain to be convinced that combining struggling hospitals into larger trusts – as with South London – will somehow produce viable organizations offering good quality, accessible healthcare.”

The report echoes the BMA’s recent comment that primary care is now suffering “mounting chaos on the ground”, showing that secondary care is facing a similar financial and organisational crisis.

The NHS is not using high-value diagnostic imaging and radiotherapy equipment to its full capacity and is failing to meet patient needs as a result, according to a report from the Government’s Public Accounts Committee.

The report, ‘Managing high value equipment in the NHS in England’, stated that poor co-operation between trusts is leading to a “scandalous” shortfall in provision of vital services such as post-stroke scans.

NHS Supply Chain has said it is working with the DH to address the issues raised by the report and the “significant challenge” of procuring costly but much-needed equipment.

The NHS in England spends approximately £50m per year on MRI and CT scanners and linear accelerators for radiotherapy. However, the Committee said, the use of this equipment to provide services is “fragmented and uncoordinated”.

The number of CT scans carried out per machine in a year was found to vary between 7,800 and 22,000, with availability ranging from 40–100 hours per week.

Shockingly, the report found that only 50% of stroke patients received a CT scan within 24 hours – an essential service for determining immediate treatment.

Margaret Hodge, Chair of the Committee, said the way high-value equipment is bought and used by the NHS “is not providing value for money”. She described the shortfall in post-stroke CT scans as “scandalous” and the inequalities in usage between regions as “unacceptable”.

“The Department of Health has got to look at how machines can be used more efficiently to make the best use of scarce resources,” she concluded.

The report highlights the challenge for the new NHS Commissioning Board to ensure that Foundation Trusts work together to ensure access to capital equipment.

Health Minister Simon Burns commented that more streamlined procurement of scanners had already begun: “The NHS has saved up to 15% on scanners by working with NHS Supply Chain to co-ordinate large orders over time with other trusts. This is the NHS working smarter.”

“We are currently working with the Department of Health to consider the recommendations in the report,” said Andy Brown, NHS Supply Chain’s Managing Director for Diagnostics. “Buying and maintaining equipment during times of budgetary restraint will provide a significant challenge for NHS trusts and our range of frameworks to plan, aggregate, purchase or lease and maintain high-end equipment will be invaluable to the NHS.”

The national programme for electronic patient records within the NHS is “unworkable” and should be abandoned, the Government’s Public Accounts Committee has said.

This verdict follows the decision to make the NHS IT programme dependent on multiple providers, with contracts negotiated locally, and the opting out of London GPs and hospitals from the scheme.

The Committee cited ongoing delays, lack of value from suppliers and existing problems with implementation as reasons for their view. It argued that having spent £2.7bn on developing an e-records system, the DH should invest the remainder of the £7bn budget elsewhere.

The aim of e-records was to make patient information more readily transferable between clinical centres and to facilitate the development and implementation of healthcare IT systems.

The £11.4bn NHS IT programme was launched in 2002 with the aim of improving the use of technology within the NHS. It has achieved the uptake of digital imaging (PACS) systems across the UK.

The e-records scheme, which aimed to give every patient an electronic file for use whenever they were treated in the NHS, was described the Committee as “a worthwhile aim” that was “beyond the capacity” of the NHS.

The Committee identified three problems: lack of value obtained from suppliers (e.g. BT charging £9m per site for services that NHS sites outside the scheme were obtaining for £2m); delays (the scheme is currently six years behind schedule) and problems with e-records currently in use.

Committee chairman Margaret Hodge concluded that “trying to create a one-size-fits-all system in the NHS has proven to be unworkable,” but that ending the national scheme might enable local NHS organisations to purchase more effective systems.

Electronic patient records will certainly play a part in the NHS of the near future – but the prospect of an integrated national system is in doubt.

NHS hospitals in England are not providing value for money, a Public Accounts Committee (PAC) report has concluded.

Figures from the Office for National Statistics (ONS) estimate that productivity has fallen by an average of 1.4% each year since 2000, despite an increase in Government spending of 70%.

Productivity is defined as the ratio of the volume of resources (inputs) to the quantity of healthcare provided (outputs), adjusted to reflect their relative costs and quality.

Government spending on the NHS increased from £60 billion in 2000-01 to £102 billion in 2010-11. The increased funding has enabled hospitals to invest in better paid staff and improve buildings and equipment.

There has been a significant improvement in the performance of the NHS since 2000, the report notes, particularly in waiting times and outcomes for patients with cancer and coronary heart disease - areas targeted by the DH.

However, productivity has not matched the increased resources, as hospitals have mainly focused their efforts on meeting national targets.

“The Department of Health will now have to work to reverse the trend of falling productivity if it is to meet its ambitious revised target of achieving, by the end of 2014-15, savings of up to £20 billion each year,” said Margaret Hodge MP, Chair, PAC.

In 2002, the DH promised that it would deliver productivity improvements of between 1% and 2% in exchange for increased funding.

It promotes efficiency and productivity improvements in hospitals primarily through national pay contracts and by a setting a ‘tariff’ for individual hospital procedures. The report says this method has resulted in certain improvements, but as the system only covers 60% of hospital activity, there is a “substantial variation” in costs and activity.

The DH is now introducing ‘best practice tariffs’ to promote greater hospital efficiency, but the report warns this may “prioritise price over quality”.

“A key problem is that national pay contracts have not so far been used to manage the performance of staff effectively. It is indicative of this that consultants’ productivity has fallen at the same time as they have had significant pay rises,” Hodge added.

NHS hospitals in England are not providing value for money, a Public Accounts Committee (PAC) report on hospital productivity says.

Despite Government spending increasing by 70% in the last decade, figures from the Office for National Statistics (ONS) estimates that productivity has fallen by an average of 1.4% per year since 2000.

Margaret Hodge MP, Chair, PAC, said that NHS productivity “has been in almost continuous decline” in the last ten years and that taxpayers have been “getting less for each pound spent”.

Productivity is defined as the ratio of the volume of resources (inputs) to the quantity of healthcare provided (outputs), adjusted to reflect their relative costs and quality.

Government spending on the NHS has increased from £60 billion in 2000-01 to £102 billion in 2010-11. The increased funding has enabled hospitals to invest in better paid staff and improve buildings and equipment.

The report notes that there has been a significant improvement in the performance of the NHS since 2000, particularly in areas targeted by the DH, such as waiting times and outcomes for patients with cancer and coronary heart disease.

But the level of hospital activity has not matched the increased resources as hospitals have focused on meeting national targets and not improving productivity.

“The Department of Health will now have to work to reverse the trend of falling productivity if it is to meet its ambitious revised target of achieving, by the end of 2014-15, savings of up to £20 billion each year,” said Margaret Hodge.

“A key problem is that national pay contracts have not so far been used to manage the performance of staff effectively. It is indicative of this that consultants’ productivity has fallen at the same time as they have had significant pay rises.”

In 2002, the DH promised that it would deliver productivity improvements of between 1% and 2% in exchange for increased funding.

It promotes efficiency and productivity improvements in hospitals primarily through national pay contracts and by a setting a ‘tariff’ for individual hospital procedures. The report says this method has resulted in certain improvements, but as the system only covers 60% of hospital activity, there is a “substantial variation” in costs and activity.

The DH is now introducing ‘best practice tariffs’ to promote greater hospital efficiency, but the report warns this may “prioritise price over quality”.