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Carter Review Says Hospitals Must Standardise Procedures

Implementing the recommendations will help end variations in quality of care and finances that cost the NHS billions, Lord Carter has advised Health Secretary Jeremy Hunt in his final report. The executive summary is available and the full report will be published shortly. His review found unwarranted variation in running costs, sickness absence, infection rates and prices paid for supplies and services.

As part of the review, a ‘model hospital’ has been developed which will advise NHS trusts on the most efficient allocation of resources and allows hospitals to measure performance against other trusts.

Following the model hospital examples could save hospitals £5 billion a year by 2020 to 2021 and put an end to the variations the review uncovered across the NHS, including:

  • average running costs for a hospital (£ per square metre) vary from £105 at one trust to as high as £970 for another
  • infection rates for hip and knee replacements vary from 0.5 to 4%
  • prices paid by different hospitals for hip replacements range from £788 to £1,590
  • the use of floor space - one trust uses 12% for non-clinical purposes and another uses as much as 69%
  • sickness absence rates differ from 3.1% to 5%

As well as reviewing hospitals across England, Lord Carter’s review looked at healthcare systems abroad, including in the US, Germany, Australia, Italy and France where hospitals have a greater focus on efficiency because they have established the clear link it has with patient care.

Lord Carter said, "My experience of the NHS and hospitals internationally is that high quality patient care and sound financial management go hand in hand. To improve the quality of care hospitals must grasp resources more effectively, especially staff, which account for more than 60 pence of every pound hospitals spend. Giving hospitals the tools and support to better manage resources will make it easier for boards to follow the example of the best trusts and mean every patient can receive the same world class care and taxpayers will also receive a fairer return on their significant investment in the NHS."

Acute NHS trusts spend £55.6 billion every year, £33.9 billion of which goes on staffing. Lord Carter estimates a 1% improvement in staff productivity will save the NHS £280 million a year, which equates to hospitals using new working methods that would save every member of staff 5 minutes on an 8 hour shift.

Other areas covered by the report include:

  • staffing: the review calls for an improvement in the way the NHS deploys its staff, ending the use of outdated and inefficient paper rosters
  • procurement: as part of the review, from April 2016, trusts will publish their receipts on a monthly basis for the top 100 items bought by the NHS such as bandages, needles and rubber gloves
  • use of floor space: trusts’ unused floor space should not exceed 2.5%, and floor space used for non-clinical purposes should not exceed 35%
  • administration costs: these should not exceed 7% by 2018 and 6% by 2020
  • delayed transfers of care: Lord Carter has called for action to be taken on the ‘major problem’ of delayed transfers of care, which affects hospitals and trusts’ earning and spending capacity
  • working with neighbouring hospitals: Lord Carter advises trusts to work closely with their neighbouring hospitals, sharing services and resources to improve efficiency and reduce costs

Lord Carter was asked to carry out the review by Jeremy Hunt as part of his aim to make the NHS the safest and most efficient healthcare system in the world. The efficiency expert has spent the last 18 months visiting hospitals across the country and reviewing productivity to ensure the NHS gets the best value from its £102 billion annual budget and help the NHS to implement a 7-day service.

Jeremy Hunt said, "I want to make the NHS the safest healthcare system in the world, capable of providing the same world class care every day of the week, powered by a culture of transparency and learning. This groundbreaking review will help hospitals care for patients, making sure every penny possible is spent on frontline patient care and bureaucracy is slashed so doctors and nurses can concentrate on caring. I’m grateful to Lord Carter, his team and those trusts involved in identifying the recommendations and urge all trusts to implement them immediately."

Lord Carter will continue to engage with and support trusts to achieve the efficiency improvements they can make over the coming months. NHS Improvement (NHSI) will lead the implementation of the recommendations and Lord Carter will become a non-executive director of the regulator in April. Lord Carter has also called for trusts to have closer support and management from NHSI, both locally and nationally, to ensure the review is fully implemented across all trusts.


Travel Advice Philippines: 7.2 Magnitude Earthquake Hits The Island Of Bohol

Around 113,282 British nationals visited the Philippines in 2012. Most visits are trouble-free. Take out comprehensive travel and medical insurance before you travel. A major 7.2 magnitude earthquake struck the island of Bohol on Tuesday at 08:12 local time (0012 GMT).

The epicentre was 629 km from Manila. Cebu City is about 60 km away. There have been some reports of casualties on Cebu. The initial earthquake was followed by two aftershocks, each measuring more than 5.0 in magnitude. The Pacific Tsunami Warning Center did not issue a Pacific-wide tsunami threat. The United States Geological Survey have issued a yellow warning saying “some casualties and damage are possible and the impact should be relatively localised.

Past yellow alerts have required a local or regional level response.”

British nationals affected by the earthquake are asked to contact the Consular Section in Manila at +63 02 858 2200.

The Foreign and Commonwealth Office (FCO) advise against all travel to south-west Mindanao and the Sulu archipelago because of on-going terrorist activity and clashes between the military and insurgent groups. The FCO advise against all but essential travel to the remainder of Mindanao for the same reasons. There is a high threat from terrorism, including kidnapping.

The FCO is aware of a credible and imminent kidnap threat against foreigners in Zamboanga del Norte Province in Mindanao.

On 10 October the US Embassy issued an emergency message to US citizens warning them of the continuing threat from terrorism in southern Mindanao, including Davao, North and South Cotabato, Sultan Kudurat, Sarangani and Maguindinao.

On 16 September 2013 the Philippine Bureau of Immigration warned foreign nationals against joining rallies and other mass action protests. Foreign nationals taking part in these rallies may face deportation for violating Philippine immigration laws.

On 9 September 2013 armed clashes took place between militants and the Philippines security forces in Zamboanga city. Sporadic fighting continues and the city’s airport has been closed. A curfew is in place from 8pm until 5am.

The FCO advise against all travel to this region. Any British nationals in Zamboanga city should remain indoors and follow the instructions of local authorities.

Around 20 typhoons hit the Philippines each year, usually between June and November. You should monitor local weather reports and follow the advice of local authorities. With the exception of Philippine Airlines (PAL), all air carriers certified in the Philippines are banned from operating to/from the EU. 


Pacific Prime Announces New Series of Annual Medical Insurance Reviews

For over 15 years, Pacific Prime has been committed to providing quality information and advice to clients to help them find the medical insurance that best suits their needs.

Pacific Prime is pleased to announce its new development for clients – a series of informative insurance reviews on different regions and the industry's top insurance providers. Every two months, starting next Friday, October 4th, Pacific Prime will be releasing an online review of the medical insurance industry over the last 12 months in a specific region, such as China, Hong Kong, Singapore, and the UAE.

The regional review will include a round-up of any medical insurance news in the region over the last 12 months, an analysis of the major news from Pacific Prime's industry experts, and predictions for the medical insurance industry in that particular region for the next 12 months. In addition to the regional reviews, every two weeks, starting the following Friday, October 11th, Pacific Prime will also be releasing a review of one of the major providers of international private medical insurance, such as Bupa International, Cigna, Now Health, William Russell, InterGlobal, Allianz, AXA PPP, Aetna, and more.

Similar to the regional reviews, the insurer reviews will include a round-up of any news pertaining to the insurance provider over the last 12 months such as any changes to plans, premiums, or any other developments. The insurer review will also include an analysis of the major news and predictions for the insurer's next 12 months. The first annual review will be for Hong Kong, and it will be released next Friday, October 4th, on Pacific Prime's website. Clients can also expect the reviews for a specific insurer or region to be released on an annual basis moving forward. With these new reports, Pacific Prime is continuing its mission of providing quality information to clients to help them make more informed decisions about their medical insurance.


Expatriates, Professionals, and Families Can All Find the Luxury Rentals They Need at Les Etoiles

Les Etoiles, a luxury rental apartment located in the center of Montreal, Quebec, is getting a lot of attention lately among expatriates, professionals and families from around the world for its beautiful and well-equipped one and two-bedroom suites. For anybody who would like to find a long-term rental in Old Port Montreal, Les Etoiles is sure to have what they are looking for. The apartments, which are a very short distance from metro stations Place d’Armes and Square Victoria, come furnished and include a wide variety of top-notch amenities like a stainless steel refrigerator, stove, microwave, dishwater, washer and dryer, hot water and 24-hour a day gym access. Indoor parking is also available upon request. For tenants looking to rent apartment one bedroom Montreal units at Les Etoiles are currently available for $1,288 a month.

Two-bedroom apartments are currently priced at $2,388 per month. (Prices are subject to availability at the time of the reservation, and may change without notice). For people who are hoping to do an international relocation to the area, and need a luxury rental in Old Port Montreal, Les Etoiles is an outstanding choice. Tenants have 24-hour interior access to the adjoining Embassy Suites Hotel by Hilton, and the metro, train station, autoroute and airport are just a few minutes away. Because each two-bedroom and one-bedroom apartment rental in Old Montreal is located in the ten top stories of the Embassy Suites Montreal Hotel, many of the suites have incredible views of the city’s skyline.

Residents often enjoy breathtaking views of the well-known Mount Royal, the Olympic Stadium tower and the Jacques Cartier Bridge. “Historic Old Montreal and the birthplace of Canada are next door with centuries-old squares, churches, cobble-stoned streets, galleries and restaurants,” an article on the Les Etoiles website noted.

“Surrounding you is the Quartier International – Montreal’s international business district that includes the Convention Centre and national and international corporations and organizations.” Anybody who would like to learn more about the Les Etoiles apartments is welcome to visit the website at any time; there, they can learn more about the luxury units that are available, and check out photos of the suites, views and amenities.

About Les Etoiles

Les Etoiles apartments for rent are located in the Embassy Suites Hotel by Hilton. The condominiums are in the historic district of Old Montreal. Aquilini Investment is a successful private family business with real estate holdings and operating entities located in almost all major cities across Canada. For more information, please visit


A.M. Best Affirms Ratings of TOWER Medical Insurance Limited

A.M. Best Asia-Pacific Limited has affirmed the financial strength rating of A- (Excellent) and issuer credit rating of “a-” of TOWER Medical Insurance Limited (TMI) (New Zealand). The outlook for both ratings is stable. TMI was sold as a wholly owned subsidiary to nib holdings limited (the nib group) in November 2012. The nib group is a health insurer established over 60 years ago and is the only listed health insurer on the Australian Stock Exchange.

Currently, the nib group provides health insurance to over one million Australian and New Zealand residents. The rating affirmations reflect TMI’s consistent underwriting results and good liquidity position, which indicates adequate margins of protection for unexpected claims and liquidity needs. The ratings also consider the nib group’s parental support in areas of strategic initiatives and risk management.

Offsetting these positive rating factors are the dividends paid by TMI over fiscal year 2013. Although TMI’s premiums continued to grow and generate positive earnings, the amount of dividends paid exceeded its net profits earned. This resulted in a decline in TMI’s risk-based capitalization, as measured by Best’s Capital Adequacy Ratio (BCAR).

An upgrading of TMI’s ratings is unlikely in the near term. Negative rating actions may occur if economic and/or industry factors lead to underwriting losses or there is a significant and continuous deterioration in the company’s risk-adjusted capitalization. The methodology used in determining these interactive ratings is Best’s Credit Rating Methodology, which provides a comprehensive explanation of A.M. Best’s rating process and contains the different rating criteria employed in the rating process.

Best’s Credit Rating Methodology can be found at Ratings are communicated to rated entities prior to publication, and unless stated otherwise, the ratings were not amended subsequent to that communication. A.M. Best Asia-Pacific Limited is a subsidiary of A.M. Best Company. A.M. Best Company is the world's oldest and most authoritative insurance rating and information source. For more information, visit


iPMI Magazine Consistently Provide Subscribers With Articles That Are Current, Interesting, And Relevant - Doug Clement, Owner at Transworld Claims Solutions Inc.

iPMI Magazine Consistently Provide Subscribers With Articles That Are Current, Interesting, And Relevant - Doug Clement, Owner at Transworld Claims Solutions Inc.

David and his hard working team at IPMI magazine consistently provide subscribers with articles that are current, interesting, and relevant. I recommend iPMI Magazine to decision makers and anyone else with an interest in gaining an up to the minute perspective on issues that affect our industry.

Doug Clement, Owner at Transworld Claims Solutions Inc.


iPMI Magazine Has Already Generated 21 Inquiries For Us - Dr. Siddick Maudarbocus, CEO Medic Assistance International

iPMI Magazine Has Already Generated 21 Inquiries For Us - Dr. Siddick Maudarbocus, CEO Medic Assistance International

We use IPMI Magazine to keep up to date with the cross border healthcare and private medical insurance industry news. We also advertise and are happy to report that in only 8 weeks we have already made profit on the advertising investment. iPMI Magazine has already generated 21 inquiries for us: 12 have already been closed; the remaining are medium term needs for 2012. Highly recommended innovative platform and process.

Dr. Siddick Maudarbocus, CEO Medic Assistance International

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