Surveys and statistics are essential tools in identifying patterns of disesase, effectiveness of treatments and care, and in suggesting new treatments to medical research. The power of modern computing and statistic applied to this data is currently termed Big Data. The NHS has a developing programme called Care.Data to gather patient data from all GP surgeries in England. The data is to be used in health services management, preventative medicine and medical research. After some public concern and some delays in the technical programme, the start to gathering data from GP surgeries has been postponed from 1st April 2014 to Autumn 2014. (continues) There is a great deal at stake. The gains in organising the NHS and in new treatments could be important. The programme has support from the British Medical Association (BMA) and the Royal College of General Practitioners (RCGP). Support has also come from a group of some 40 well-known medical charities. These charities include The British Heart Foundation, the Alzheimer's Society, Cancer Research UK and the Wellcome Trust. They see the benefits to treatment and to medical research of gathering this data. You can find out more about the Care.Data programme at www.nhs.uk/NHSEngland/thenhs/records/healthrecords/Pages/care-data.aspx and about the NHS secure data centre at www.hscic.gov.uk . Sharing of data between your GP and others is covered by the Data Protection Act and by the NHS's own data protection principles known as the Caldicott principles. Under the Data Protection Act you can ask any organisation that holds identifiable data about you to show you your own records. This is not the only programme for sharing your data outside your GP's surgery. Unless you have opted out, a record called the Summary Care Record, detailing your current medications, allergies and bad reactions will be maintained at a national centre. This will be available to healthcare staff treating you, for example in an emergency, subject to your consent, provided that you are in a position to give it. You can find out more about NHS summary care records at www.nhscarerecords.nhs.uk. Hospital treatment records have been collected in this way for some decades, apparently without scandal or offence. The innovation is now to do the same for general practice and community nursing and to allow these data to be linked with the hospital treatment records. In addition, details of your medical history will also be shared on a need to know and case-by-case basis between your GP surgery and other healthcare and social care staff treating you, for example district nurses, hospital doctors, social workers and so on. All the healthcare and social care staff treating you are legally bound to protect your confidential data. The proposed Care.Data programme, now postponed until Autumn 2014, will required medical histories to be uploaded to a national centre for this data, the Health and Social Care Information Centre (HSCIC). Here GP data can be linked with hospital data to allow the course of a medical condition to be thoroughly tracked. Data sets can be passed to researchers for specific projects or published. The constraints on keeping data confidential are strict and insist that it should be impossible to learn and new definite information about you from the published or supplied data. Where it is sufficient that the numbers of patients in different categories be passed on (aggregated data), that will be done, but even then there are strict limits on identifying small groups so that individual confidential information cannot be identified. The data held at the Care.Data centre (HSCIC) will be pseudonymised so that identifying details like name, NHS number, postcode, age will either be omitted or represented by broader categories so that no individual could be identified. The identifying details are replaced by a made-up identifier which can still be used to link together different records belonging to the same individual. The programme is currently examining whether that pseudonymising could be done at the GP surgery before exporting the data to the secure centre. You can find out more about pseudoynmised data at www.openpseudonymiser.org It is envisaged that other secure centres may be licensed to receive this data. It is not clear whether these will be public or private centres. They will have to follow the same strict rules as HSCIC. It is useful to realise that the HSCIC should not be organised like the Police National Computer or Vehicle Licensing Agency where thousands of staff have access to individual records, and corruption has, sadly, sometimes led to the loss of confidentiality in some cases. It should not be organised to provide identifiable individual records. An NHS England campaign has been mounted to deliver an explanatory leaflet to every household explaining the Care.Data programme, its potential benefits and how to opt out if so desired. This doesn't seem to have been very successful. The information provided on the full extent of the programme and the powers of HSCIC have not really got across to the public at large. The six-month postponement gives a chance for a clear case to be made for the programme, with clear boundaries delimited, so that greater public understanding and consent can be gained for the research and organisational benefits of this programme to be realised.

The NHS is to moderate its underpayment of hospitals for seeing patients in A&E, the Guardian website reports. A big headache for NHS hospitals has been that theyt have not been getting full fees for patients attending A&E. Instead they get only 30% of the fee for every patient more than seen in the year 2008/9. With steeply rising attendance this has put finances under strain. CCGs have been advised to spend the money withheld with providers. Locally some of the money withheld from the RBH has returned to it but by no means all the money withheld. It is now reported that Monitor, the organisation which is charged with supervising providers and setting the treatment tariffs, has decided that CCGs and providers will have to agree their own threshold for withholding part of the fee, and will have to show that money withheld is being spent on alternatives to A&E. Although CCGs are getting a little more money (in real terms) this year than last, some is being transferred to a pooled budget with Social Care, so this wil put local budgets under further strain. South Reading NHS CCG has indicated that it will work to keep more patients in their own homes rather than in hospital, where appropriate, with its projected "Hospital at Home" programme, of which we expect to hear more in the coming months.

We will be meeting between 6pm and 7:30pm on Wednesday, 27th November at the University Health Centre, 9, Northcourt Avenue, Reading RG2 7HE The main feature will be a presentation on South Reading's Health Needs as assessed in the annual Joint Strategic Health Assessment (JSNA) by the Reading Borough Public Health Team. The assessment forms the basis of local commissioning of hospital and community healthcare by the CCG for the next two-year and five-year periods. News from local practice Patient Groups will be welcome. All members welcome - to join please use the form on this web site.

We will be meeting between 6pm and 7:30pm on Wednesday, 29th January 2014 at the University Health Centre, 9, Northcourt Avenue, Reading RG2 7HE The main feature is expected to be a presentation on South Reading's Health Needs as assessed in the annual Joint Strategic Health Assessment (JSNA) by the Reading Borough Public Health Team. The assessment forms the basis of local commissioning of hospital and community healthcare by the CCG for the next two-year and five-year periods. News from local practice Patient Groups will be welcome. All members welcome - to join please use the form on this web site.

The Reading FIRST bus will be offering first aid, health and recovery services in Hosier Street on Friday and Saturday nights from 9pm to 4am. The service has been an initiative of Reading Borough Council's Health and Wellbeing Board and is supported cooperatively by NHS CCGs, Police, Ambulance Service, Reading Borough Council, Reading Local Strategic Partnership and the Government. The aim is to help those who get into difficulties in the town centre at night and to take the load of the RBH A&E department. You can read the Reading Chronicle report on the introduction of the FIRST bus here.

South Reading NHS CCG will be getting above inflation funding increases for the next two years with 3.3% (3.6 million) for 2014-15 and 2.82% the next year. This is above the national average as our funding per head is one of the lowest in the country. However, it is below the average for the Thames Valley as the Government has shifted the balance from deprivation to elderly care and other Thames Valley CCGs have an older population. You can read what CCG chair Dr. Elizabeth Johnston has to say about the increases. Some of these funds are being transferred to Social Care under joint funding arrangements so not all of this increase is for the health budget as most people understand it.

Dr Elizabeth Johnston, chair of the South Reading NHS CCG has been looking at the work of the Community Rapid Response Team in the South Reading CCG area and has provided us with the following short report: Within the Berkshire West Area South Reading CCG is the highest user of the Community Rapid Response and Reablement team (CRRTeam) and has the lowest number of admissions to hospital within four weeks of using the team. Outcomes for patients who have been through this community service are also encouraging with the lowest percentage for deterioration, hospital admission and death. Of the patients who were admitted to hospital, discharged but readmitted later many of these were for new symptoms unrelated to the previous admission. GPs within South Reading CCG wish to support ill patients at home where it is not necessary for them to go to hospital for specific treatment; therefore the CRRTeam, which provides nursing, occupational therapy and physiotherapy input to patients in their own home, along with homecare input up to 4 times a day for 6 weeks, is showing to be a successful service to enable this to happen and to reduce avoidable hospital admissions. Referrals can be made by GPs to this service via the Health Hub 7 days a week

The Cardiac unit at the Royal Berkshire Hospital has been judged fastest in the nation with 96% of patients undergoing the recommended treatment of primary angioplasty within 150 minutes of a 999 call, reports the BBC.

According to the BBC NHS Winter tracker the week starting 28th November 2013 at Royal Berkshire Hospital brought many bed closures due to Norovirus and many cases of "bed blocking" where patients cannot be discharged for lack of immediate care facilities for them outside the hospital. The consequence has been longer waits in the Accident and Emergency department where attendances increased and admissions increased more. Please see the attached report for more details.

National Research by the Dr Foster group associated with Imperial College, London, as reported by the BBC, has suggested that the NHS is rationing elective operations such as knee replacements, hip replacements and cataract removals. With an ageing population the numbers of such operations could be expected to rise steadily.