The NHS Commissioning Board (NHS CB) has appointed Neil Churchill as its first Director of Patient Experience.

Mr Churchill joins from Asthma UK, where he has served as Chief Executive since 2007. He is also currently a Non-Executive Director in NHS South of England.

Jane Cummings, Chief Nursing Officer, NHS CB, said the new recruit has a “fantastic amount of experience” and he will be a “great addition to the skilled and experienced staff we currently have.”

In his new role, Mr Churchill will be responsible for ensuring patient experience is at the heart of the system, to provide leadership for patient experience across the NHS and to take leadership responsibility for improvement of domain four of the NHS outcomes framework (patient experience).

“I am delighted to be joining the NHS Commissioning Board at this time of change, when there is real commitment and drive to put the patient at the centre of decision-making,” commented Mr Churchill. “We need to make sure that every patient receives safe, compassionate care but we also have the opportunity to forge a new partnership with patients which can improve productivity as well as health outcomes.”

Prior to joining Asthma UK, Churchill worked for a number of organisations in the voluntary sector, including Barnardo’s, Age Concern and Crisis.

The NHS Commissioning Board will be allowed to use patient data to enable CCGs to compare their performance against other commissioners.

The GPES Independent Advisory Group (IAG) has approved the use of the General Practice Extraction Service (GPES) for patient-anonymised data on demographics, diseases, events and referrals from GP systems.

The Commissioning Board said the data would be used by CCGs to analyse outcomes, compare data between different practices and to map lifestyle factors against public health estimates.

Although the Board is now free to cherry pick data on a monthly basis, the IAG has ruled the action is dependent on three conditions. The NHS CB must clearly define the purpose of data extraction; the BMA and RCCP should be involved in discussions around what data is used; and that the extraction of data will maintain patients’ rights at all times in line with the NHS Constitution.

Critics of the move have voiced concerns that patients will be unaware that private information will be used for purposes other than their care. Dr Paul Cundy, Chairman of the General Practitioner Committee IT subcommittee, called for a public campaign to raise awareness of the change in data protection.

His colleague, Dr Chaand Nagpaul, GPC’s lead negotiator on IT, also backed measures to raise understanding of what the changes mean for patients. “We need to be confident that the rights of the public are respected,” he said. “It is vital the public are fully aware that these extractions are taking place. It’s unlikely a website in itself will be enough.”

The NHS Commissioning Board (NHS CB) has backed all 62 clinical commissioning groups in the third wave of its authorisation process to take on new their responsibilities from 1 April 2013.

Six CCGs were authorised without any conditions but five groups will be given intensive support in their development after concerns were raised. The remaining 56 CCGs were authorised with conditions.

The completion of the third authorisation wave means that 163 of the 211 CCGs across England have now been given the green light to take on their new commissioning responsibilities. From 1 April 2013, CCGs will be responsible for £65bn to commission local health services.

Dame Barbara Hakin, NHS CB National Director: Commissioning Development, said that the “majority of CCGs are now authorised and up-and-running”.

The five CCGs which were singled out for concern are NHS Eastbourne, Hailsham and Seaford CCG, NHS Newham CCG, NHS Herefordshire CCG, NHS Scarborough and Ryedale CCG and NHS Vale of York CCG. The NHS CB said these groups will still be able to take control of their individual commissioning budgets but will be given “intensive support”.

Issues raised by the board include the clear and credible integrated plans of NHS Eastbourne, Hailsham and Seaford CCG, NHS Herefordshire CCG, NHS Scarborough and Ryedale CCG and NHS Vale of York, plus the financial systems and processes used by NHS Newham CCG.

The remaining 48 CCGs are set to authorised next month.

The Department of Health has published a ‘pledge’ to improve health outcomes for children and young people through co-ordinated activity across the NHS.

Stated aims include a reduction in the child mortality rate, improved care for children with long-term conditions, and better mental health care for the young.

A new Children and Young People’s Health Outcomes Board, led by the Chief Medical Officer, will focus on improving outcomes across paediatric care.

The DH is responding to a report from the Children and Young People’s Health Outcomes Forum, warning that child mortality rates in England are among the worst in Europe and that 26% of children’s deaths are linked to failures in direct care.

The Forum calls for attention to obesity, maintenance of long-term conditions, earlier diagnosis of mental health disorders, and better attention to the health needs of looked-after children.

GPs will be offered specialised training or support in paediatric health, and provided with new colour-coded health maps showing trends in conditions such as asthma and diabetes.

The CCGs will be asked to review their provision of services for children and investigate poor outcomes.

The DH also said it would investigate proposals by the Royal College of General Practitioners to extend GP training for a fourth year to include child health and mental health.

Health Minister Dan Poulter said: “It is a shocking fact that child mortality in Britain is the worst when compared to other similar European countries. There is unacceptable variation across the country in the quality of care for children – for example in the treatment of long-term conditions.

“Our pledge demonstrates how all parts of the system will play their part and work together to improve children’s health.”

Hilary Cass, President of the Royal College of Paediatrics and Child Health, commented: “It’s crucial that this momentum is maintained and that outcomes are regularly measured to drive improvements.

“We will be directly involved in a number of areas, which include enhancing the use of medicines in children and working with GPs to ensure paediatrics is part of their training.”

Signatories to the pledge include the DH, Healthwatch, the NHS Commissioning Board, NICE, MHRA and Public Health England.

A key principle of the pledge is that improving children’s health outcomes will not only reduce child mortality but lay the foundations for healthier adult lives.

In the new Pf, Health Secretary Jeremy Hunt answers some questions from our readers. Maxine Vaccine delivers a brief audit report on his answers.

The most vital thing to remember about Jeremy Hunt is that he’s not Andrew Lansley. The older man spent nine years dreaming up a transformation of the NHS into a competitive healthcare market system, then claimed he’d had to invent it out of thin air when, as part of the new coalition government, he “saw the books” (which he’d had full access to for nine years) for the first time. Then he drove through legislation designed to break up the NHS and place its fragments on the bargain shelf of global corporate business, and mocked anyone who questioned it. Forced into a cosmetic display of ‘consultation’, he followed it up by declaring that the ‘listening period’ had been needed only to educate the ignorant doctors.

And suddenly, the Tories are faced with the prospect of losing power. Journalists are calling the Health and Social Care Act ‘Cameron’s poll tax’. Cue the new Department of Health. Exit the sneering headmaster and enter the elegantly half-smiling head boy. Who doesn’t half scrub up well, and – unlike Lansley – can say “the NHS is one of our greatest assets” without crossing his fingers behind his back. Jeremy Hunt was a contributor to Direct Democracy (2005), a Conservative Party activist guide that claimed the NHS was “no longer relevant” to modern society because it was a public sector health system. But he can say “the NHS is one of our greatest assets” because he can say anything. Lansley is a Thatcher type of politician, whereas Hunt is a Blair type.

His answers to the Pf questions are classic examples of why he has been drafted in to front NHS reform up to the next General Election, or at least part-way there. He never says the wrong thing. If he can’t say the right thing, he says nothing in a nice way. He makes you feel that anyone who disagrees with him must be insane. It’s only when you compare his words with what is actually going on that things get complicated – and you realise that, as a new lease-holder in the house that Lansley built, he has only unpacked the suitcases for two rooms: the front room and the bathroom. The rest of the house is unoccupied.

Regular Pf contributor Omar Ali asked Hunt a question about NHS rationing: how will making patients pay for services be integrated into the wider healthcare bill implementation? A good question, as this is already happening: patients in many areas are being told they cannot have cataract operations, varicose vein surgery or hip/knee replacements unless either (a) they wait until their need is greater (for example, they can have cataract surgery once they are blind) or (b) they go private. Referral management, which Sir David Nicholson is very keen on, is another form of rationing: if patients want to see a specialist in many situations, they have to go private. Hunt’s response is worth quoting in full:

Let me be absolutely clear on this – the NHS will always be free at the point of delivery and no one will be asked to pay for its services. Yes, in the future, services will be provided differently – public health services will be organised by local authorities, for example – but the founding principle of those NHS services being free, for those who need it, will never change.

Hunt is neatly splitting the hair of Omar Ali’s question. If people are paying for services they are not NHS services, they are private. But money will still be changing hands for services that used to be free. They just won’t be NHS services any more. And that “for those who need it” is significant. It has two aspects: severity of clinical need (already a moveable famine) and ability to pay (Direct Democracy suggests the NHS should become a means-tested state reimbursement of private healthcare fees). Who needs free healthcare, and what free healthcare they need, will be critical issues from now on – and legally, the Health Secretary now has no remit to influence those decisions, which will be made by autonomous CCGs and/or the autonomous Commissioning Board.

Pf reader Susan Ranch asked whether the Government’s recent announcement that it will cap individual payments for social care at twice the Dilnot-recommended level means that more NHS funding will be committed for elderly patients. Hunt replied: This is incorrect. The Government has not said this and no decision has been made. Strictly speaking, he is right. According to the BBC and three Tory-loyal newspapers (the Sunday Times, the Daily Mail and the Daily Express), journalists were briefed that setting the social care payment cap at £75k (whereas Dilnot had recommended £35k) would feature in the Government’s mid-term review. But it did not – and the critical backlash from social and healthcare experts was either unnecessary or effective, depending on your interpretation. Whatever its level, the cap appears unlikely to be implemented before the 2015 election.

Hunt went on to say: I want this country to become one of the best places in Europe to grow old and make sure people can live independent and healthier lives into old age. Which is the kind of gold-plated soundbite Lansley never delivered.

Another Pf reader, Leigh Saunders, asked how the pharmaceutical industry could work with the NHS to improve cancer survival rates. Hunt replied: The pharmaceutical industry already plays a vital role in improving the health of people with cancer. I want to improve mortality rates, where the targeting and development of medicines is becoming ever more important. I am sure the pharmaceutical industry will want to build on its work in this area and help improve cancer care.

Great stuff: that flatters the industry, expresses a decent medical aim, and then flatters the industry again. It doesn’t answer the question, but who cares?

Jeremy Hunt’s management of the Pf questions is a masterclass in accessible spin. It tells us almost nothing about Government policy, but it tells us why Hunt currently holds the lease on the house of NHS reform. He knows how to make it look good – and in politics, that’s not always easy. The pharma industry should recognise Hunt’s talents as those of marketing and sales. He’s one of us.

Maxine’s views and attitude are not necessarily those of Pf.

Ian Dalton, the Chief Operating Officer and Deputy Chief Executive of the NHS Commissioning Board (NHS CB), will leave the National Health Service for a role at telecommunications giant BT.

The experienced NHS boss has decided to swap the public sector for the private sector after accepting the role as President of Global Health at BT Global Services.

The former Chief Executive of NHS North of England said it had been a “huge privilege” to have worked and contributed to the NHS over a number of years.

“I have been impressed by the NHS Commissioning Board’s passionate focus on the interests of patients and I am confident it will deliver real improvements for the future. For the next period, my focus will be on delivering what I am sure will be a successful transition for the operations directorate of the NHS Commissioning Board.”

Sir David Nicholson, NHS CB Chief Executive, thanked the departing Dalton for his efforts over a number of years. “I would like to take this opportunity to thank Ian for his significant contribution and dedication to the NHS over many years,” he said. “Ian has worked incredibly hard to drive forward better health outcomes for patients. Ian will be missed and I wish Ian all the best in his new role at BT.”

The date of Dalton’s departure from the NHS CB has not yet being specified.

Mr Dalton is the second high profile member of staff to leave the NHS for a role in the public sector. Jim Easton, the former Director of Transition at the NHS Commissioning Board and as the National Director for Improvement and Efficiency at the DH, formally stood down his roles in November to join Care UK, an independent provider of health and social care.

The NHS Commissioning Board has authorised a further 67 clinical commissioning groups to take on local responsibilities for healthcare budgets and services.

All CCGs in the ‘second wave’ of the Board’s authorisation process were approved – although three Groups will be given ‘intensive support’ after serious concerns were raised by the Board.

Dame Barbara Hakin, the NHS Commissioning Board’s National Director: Commissioning Development, said the “vast majority” of CCGs “demonstrated excellence” and were now ready for the “challenge of leading their local health communities”.

The three CCGs which the Board will continue to support as they continue to develop are NHS Nene CCG, NHS Herts Valleys CCG, and NHS Medway CCG.

Concerns raised by the Board include the financial modelling and implementation plan for NHS Herts Valley CCG; that the board at NHS Medway CCG builds a greater understanding and ownership of its financial plan; and that NHS Nene CCG uses nearby NHS Corby CCG as its lead commissioner for Kettering General Hospital NHS Foundation Trust.

Nineteen of the 67 CCGs have been authorised with no conditions after they met all of the 119 criteria set by the NHS CB. A further 45 have been authorised with conditions, with the Board providing some formal support to help continue with their development.

Of the 211 CCGs across the country, the remaining 110 are now set for authorisation over the next two months. “Almost half of the CCGs are now authorised and we are moving at pace towards a clinically-led NHS that is focused on delivering improved health outcomes, quality, innovation and public participation,” said Dame Barbara.

“Authorisation is just the beginning: these new organisations will continue to develop, and I am confident patients will start to see real benefits in their local areas as CCGs begin to realise their potential.”

The managing director of South Yorkshire and Bassetlaw Commissioning Support Unit (CSU), Ming Tang, will depart from her role to join the NHS Commissioning Board.

Ming Tang will leave the CSU later this month to take up her new role as Director for Data Information Management Systems at the Commissioning Board.

She will be replaced at the CSU by Alison Hughes, the current MD of West Yorkshire CSU – who will take on responsibility for both units.

The Commissioning Board say the changes have been made now to “ensure maximum stability” for CCGs as they continue through the authorisation process.

The NHS Commissioning Board is expected to cost taxpayers £1.4 million a day, a new investigation has found.

Information obtained by the Sunday Express found the Board, which officially takes on its full responsibilities from April, will cost £527m to run this year.

The Board’s chief executive, non-executive chairman and nine national directors are all on salaries higher than Prime Minister David Cameron and initial staff levels have been forced to rise from 3,500 to 5,900 in 2013-14.

Matthew Sinclair, Chief Executive of the TaxPayers’ Alliance, told the newspaper that the “last thing patients and taxpayers need is another overly bureaucratic and unaccountable NHS super-quango.”

Rising staff costs have forced the NHS CB to seek approval from Health Secretary Jeremy Hunt to increase its budget for 2013-14. As a result, the Board’s operating budget has been adjusted by £35m to cover additional personnel.

The Board has already used some of its £30m contingency fund to pay for rising costs and allocated £28.5m fund for “discretionary expenditure” that will be used on “external support” in communications and analysis.

The NHS Commissioning Board has identified the enforcement of generic prescribing as one of its key priorities for 2013.

A study commissioned by the Board found the NHS could save £200m per year by replacing two branded statins with generic alternatives, and annual savings of up to £1bn could be achieved across all prescribing.

The study recommends that GPs with expensive prescribing habits should be required to explain their decisions to the CCG – thus potentially creating conflicts between CCGs and pharmaceutical companies.

An embargo on branded drugs where generic versions exist could also see deep erosion of the specialised biopharmaceuticals market by biosimilars.

Branded drugs are often more recognisable, easier to swallow and even easier to digest than generic alternatives – but they can cost up to 25 times as much.

Open Health Care UK and data research company Mastodon C analysed the prescribing of two statins across the country. Many GPs were still prescribing branded versions, despite the availability of generics.

The Board’s Medical Director, Sir Bruce Keogh (pictured), said: “Variation in prescribing habits costs the NHS millions of pounds a year. Sharing of information will help clinicians understand whether they are over- or under-prescribing.

“This will focus minds in a way that will not only improve the quality of treatment for patients but also reduce cost and free up money for reinvestment.”

According to experts cited by The Independent, two mechanisms underlie the over-prescribing of brands: GP practices with on-site pharmacies have an incentive to prescribe branded drugs as they generate more profit; and hospitals buy branded drugs in bulk, reducing the cost but creating an ongoing patient expectation.

Open Health Care UK and Mastodon C will develop software to help the new CCGs target local GPs whose prescribing practices are expensive.