Health & Care Review

Health & Care Review

February 5, 2018

Keeping up with all the latest developments in health and care policy could almost be a full time job and PSNC regularly receives questions from LPCs and pharmacy contractors about what is going on in the wider health and care landscape beyond community pharmacy. To help answer some of these questions and to help contractors and LPCs stay up to date, PSNC provides this update service outlining the latest information in an easily digestible format. Weekly updates are published on our website and contractors can ensure they do not miss them by signing up to PSNC’s email newsletter service here.

The reviews extend the work we have been doing for some time to help LPCs stay informed about the NHS changes, and they inform the more detailed PSNC briefings which we continue to publish on this topic; these can be accessed in the Healthcare Landscape section of the website.

In and out of hospital: how to stop avoidable admissions

The British Red Cross has published a report focussing on avoidable hospital admissions among vulnerable patients. The report is the culmination of a programme of research undertaken by the charity to highlight the stress the health and social care system is under.

The charity has tried to identify some relatively simple steps it believes could improve patient flow. The recommendations made in the report relate to helping people feel safe at home, avoiding unnecessary hospital admission, and helping people home from hospital.

They include:

  • automatic home assessments should be triggered for people who have come in and out of hospital several times within a few months;
  • establish more multidisciplinary teams who work with people at risk of being admitted into hospital;
  • all discharge ‘checklists’ must include an assessment of equipment and medication needs, from wheelchairs to blister packs, arranged before the patient leaves the hospital;
  • transport home from hospital should be offered to all those living alone and have poor mobility;
  • frail patients whose transfer back to the community has been delayed should be encouraged and assisted to get dressed and walk around every day they are in hospital so that their condition does not deteriorate; and
  • those who live alone, have poor mobility and who have been in and out of hospital due to falls should automatically have their home assessed for falls hazards before discharge.

Uptake for routine breast screening falls

NHS Digital has published a report relating to the breast screening programme which highlights that uptake is at the lowest rate over the ten-year period.

Under the NHS Breast Screening Programme, eligible women will usually receive their first routine invitation for breast cancer screening between the ages of 50 and 53 and will normally be invited every three years until they are 70.

The report shows that the proportion of women aged 50-70 taking up routine breast screening invitations fell to 71.1% in 2016/17 down from 72.1% in 2015/16 and 73.6% in 2006/07.

New figures show larger proportion of strokes in the middle aged

Public Health England (PHE) has re-launched its Act FAST stroke campaign, which urges people to call 999 if they notice any of the signs in themselves or others.

New statistics from PHE relating to stroke include:

  • approximately 57,000 people in England experienced a stroke for the first time in 2016;
  • stroke incidence increases with age; 3% of the total estimated stroke incidence occurred in people aged under 40, 38% in people aged 40 to 69 and 59% in people aged over 70;
  • strokes are occurring at an earlier age; age at onset fell from 70.5 to 68.2 in males and 74.5 to 73 in females between 2007 and 2016;
  • incidence of stroke appears to be highest in the most deprived population, although the difference between the most and least deprived is not significant.

Prescribed medicines that may cause dependence or withdrawal

The Parliamentary Under Secretary of State for Public Health and Primary Care has commissioned PHE to review the evidence for dependence on, and withdrawal from, prescribed medicines.

The review will bring together the best available evidence on:

  • prevalence and prescribing patterns;
  • the nature and likely causes of dependence or discontinuation syndrome among some people who take these medicines; and
  • effective prevention and treatment of dependence and discontinuation syndrome for each drug category.

The review was launched on 24th January 2018 and is due to report in early 2019.

How have public attitudes to the NHS changed over the past three decades?

The King’s Fund has published an article on the public’s view of health care, based on the British Social Attitudes survey (conducted by NatCen Social Research) undertaken every year since 1983.

Key facts include:

  • the public wants the government to spend more on health care, putting it first in line for any extra government spending;
  • when people have been asked, ‘Which, if any, area of public spending would be your highest priority for extra spending, and which next?’, health has always been placed at the top of the list, with education a close second;
  • most people want the government to be responsible for providing health care;
  • most people responding to the survey have supported the concept of a health service that is not means-tested; and
  • levels of public satisfaction with the NHS have fluctuated over the past 34 years, but in 2016 the public reported high levels of satisfaction with the NHS.

Brexit could disrupt supply of medicines, Brexit Health Alliance warns

NHS Confederation has published a paper by the Brexit Health Alliance which warns that patients could face disruption to the supply of their medicines when the UK leaves the European Union (EU).

The report describes how EU regulation on medicines and medical technologies has benefited patients and includes case studies relating to different medicines.

The report makes a series of calls, which include ensuring no negative impact on patients, guaranteed patient safety and public health, pragmatic solutions, a cooperation agreement between the UK and the EU on regulation of medicines and medical devices and an implementation period beyond the two years of Article 50 negotiations.

Expand the nursing workforce at scale and pace, says the Health Committee

The House of Commons Health Committee has published a report, The nursing workforce, which states that too little attention has been given to retaining nurses in the NHS, causing more nurses to leave than join the profession.

Key facts in the report include:

  • over 29,000 UK nurses and midwives left the Nursing and Midwifery Council register in 2016/17, 9% more than the previous year;
  • there are almost 5000 fewer nurses working in community settings since 2010; and
  • The UK has fewer nurses relative to the population than the Organization for Economic Cooperation and Development average, and it is also below many EU countries and traditional comparator countries.

The authors of the report are calling on the Government to:

  • expand the nursing workforce at scale and pace and pay more attention to retaining the existing workforce;
  • increase the opportunities for nurses to access high quality continuing professional development and improve their working conditions;
  • monitor the impact of removing nursing bursaries, especially on mature students taking nursing degrees; and
  • make sure that Nursing Associates have a clear professional identity, which is explained to the public.

Patient safety review and response: October 2016 to March 2017

NHS Improvement has published a report to provide a summary of how it has reviewed and responded to the patient safety issues reported to the National Reporting and Learning System (NRLS).

Key facts highlighted in this report, which covers the past six months, include:

  • 9,769 incidents were reported to the NRLS with an outcome of death or severe harm;
  • 43 incidents were reported by patients of the public; and
  • 3 letters were received from coroners where they have identified a need for action to prevent further deaths.

The report also discusses when various alerts are issued and specific actions are taken.

Lawyers who target the NHS banned from advertising or setting up shop in hospitals

NHS England has announced that NHS hospitals will no longer provide office or advertising space for law firms or claims management companies who encourage patients or their families to take the NHS to court.

Following a consultation exercise, the new rules have been introduced through changes to the NHS Standard Contract under which NHS Trusts and Foundation Trusts operate. The new ban came into effect on 1st February 2018.

NHS England sets out plans to be first in the world to eliminate Hepatitis C

NHS leaders have called on the pharmaceutical industry to work with them to provide best value for money for treatments so that in its 70th year, the NHS can commit to eliminating Hepatitis C in England at least five years earlier than the World Health Organization goal of 2030.

Identifying more people living with Hepatitis C who need to be treated is part of a new agreement between NHS England and drug companies; it is expected that this approach combined with existing approaches could lead to the infection being eradicated as a public health concern in the very near future.

Media monitoring:

On Monday 29th January 2018 the following story was published:

  • The Express reports on the return on Victorian diseases including rickets, Tuberculosis and scurvy.

On Wednesday 31st January 2018 the following stories were published:

  • The Guardian reports that women’s experience of NHS maternity care is improving but almost one in four mothers are still being left alone during labour or birth, a major new survey reveals. This was also covered by the Times and the Sun.
  • The Daily Mail has reported on comments by health officials that a smoke free generation is now ‘within sight’, on the back of new figures showing a further drop in smoking rates. Data released shows nearly 66,000 adults dropped the habit in the space of six months.
  • The Financial Times reports that the cap on skilled visas for non-EU workers was reached two months in a row for the first time, contributing to the NHS’s difficulty in recruiting doctors from overseas.

On Friday 2nd February 2018, the following stories were published:

  • Health service leaders have warned the Justice Secretary that the rising cost of clinical negligence claims against the NHS is “unsustainable” and payouts to victims should be reduced otherwise they could bankrupt the NHS, says The Guardian. This story was also covered by the BBC,  The Telegraph, The Times, The Daily Mail and The Sun.
  • A poll by The Mirror finds that 73% of the public would pay an extra £1 a week to provide further funding for the NHS.
  • The BBC reports on new figures which show that deaths from prostate cancer have overtaken those by breast cancer for the first time. This makes prostate cancer the third biggest cancer killer in the UK.
  • The Independent reveals that the NHS is reviewing the results of smear tests after thousands of women were found to have wrongly been given the all-clear. This story was also covered by The Telegraph and The Sun.

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