Health & Care Review

Health & Care Review

July 17, 2017

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.

Big cuts planned to public health budgets

The King’s Fund has published a new analysis, based on data from the Department of Communities and Local Government, highlighting how central Government cuts have forced councils to reduce planned spending on vital public health services.

The analysis estimates that planned public health spending in 2017/18 will be reduced by more than 5% in comparison to 2013/14. Figures also show that councils are planning to spend more on some services such as promoting physical activity and some children’s services, however, most services are planned to be cut.

Services which are estimated to have reduced spending include:

  • sexual health services – spending is to be reduced by £30 million compared to last year, a 5% cut;
  • tackling drug misuse in adults – spending is to be reduced by more than £22 million, a 5.5% cut; and
  • stop smoking services – spending is to be reduced by almost £16 million, a 15% cut.

David Buck, Senior Fellow in Public Health and Inequalities at The King’s Fund, said: ‘These planned cuts in services are the result of central Government funding cuts that are increasingly forcing councils to make difficult choices about which services they fund.

Reducing spending on public health is short-sighted at the best of times. But at a time when the rate of syphilis is at its highest level for 70 years, to cut spending on sexual health services is the falsest of false economies and is storing up problems for the future.

The Government must reverse these cuts and ensure councils get adequate resources to fund vital public health services.’

Drug strategy 2017

The Home Office has published Drug strategy 2017, which sets out clear expectations for action from a wide range of partners, such as those in education, health, safeguarding, housing and employment to tackle drug misuse and the harm it causes.

The document outlines the action that needs to be taken at a national level to support local areas to ensure everyone plays their role in reducing demand, restricting supply, building recovery and driving action on a global scale.

Health profile for England

Public Health England (PHE) has published a landmark report, Health Profile for England, which compiles PHE’s wealth of population data to provide an overall snapshot of health in England.

The report comprises seven chapters, which can be read alone or as a series. These are:

  1. life expectancy and healthy life expectancy;
  2. major causes of death and how they have changed;
  3. trends in morbidity and behavioural risk factors;
  4. European comparisons;
  5. inequality in health;
  6. social determinants of health and
  7. current and emerging health protection issues.

Key facts identified in the report include:

  • life expectancy has increased more than years in good health and therefore the number of years lived in poor health has also increased;
  • diabetes makes the top 10 causes of ill-health and disability (morbidity) for the first time;
  • the two biggest risk factors behind levels of ill health are excess weight and high blood sugar;
  • lower back and neck pain are the biggest causes of ill health;
  • while deaths from heart disease and stroke have halved since 2001, it’s still the biggest killer of men; and
  • the biggest killers for women are Alzheimer’s disease and dementia.

Health equity in England

PHE has published a report which features an analysis and commentary on inequalities for 18 indicators from the Public Health Outcomes Framework, which are used to monitor health inequalities in England.

Key facts identified in the report include:

  • there has been little change in the gap in male life expectancy, male and female healthy life expectancy and premature cancer mortality;
  • for female life expectancy, there has been a small widening of the gap between the most and least deprived areas;
  • for premature cardiovascular disease mortality, considerable inequality by deprivation remains, with mortality rates in the most deprived tenth of areas almost 3.5 times higher than those in the least deprived tenth of areas between 2012 and 14; and
  • although we have seen a general improvement across indicators reflecting PHE priority areas, for example, falling smoking prevalence, tuberculosis (TB) incidence and percentage of people reporting low life satisfaction, the most recent data show wide inequalities across all indicators related to child health, mental health, smoking, alcohol misuse, and TB, and no trend indicating a clear narrowing of these inequalities.

Adult Social Care: Quality Matters

The Department of Health and the Care Quality Commission have published Adult Social Care: Quality Matters, a resource which sets out a single view of quality and a commitment to improvement in relation to adult social care.

The list of priorities identified in the action plan are:

  1. acting on feedback, concerns and compliments;
  2. measuring, collecting and using data more effectively;
  3. commissioning for better outcomes;
  4. better support for improvement;
  5. shared focus areas for improvement; and
  6. improving the profile of adult social care.

More than a quarter of women missing smear tests are unaware they exist

Cancer research UK has published an article highlighting that more than a quarter (28%) of women who are overdue for a smear test are unaware of the national cervical screening programme. This lack of awareness was higher among women with English as a second language from minority ethnic groups and women from lower income families.

A survey commissioned by Cancer Research UK also showed that around half of those overdue for the test said they intended to go in the future and these were more likely to be younger women aged 25-34. However, 15% of those overdue said they had decided not to attend at all and these were more likely to be older women, aged 55-64.

Lack of confidence in STPs, councils warn

The Local Government Association (LGA) has published the findings of a survey it conducted on councillors on their perceptions of Sustainability and Transformation Partnerships (STPs).

Key findings from the survey are:

  • while more than 90% of responding councillors knew about STPs, just 21% said they had felt sufficiently engaged in their STPs;
  • under 25% of responding councillors are confident that their STP will deliver on its objectives or bring benefits to their local communities; and
  • not a single respondent had reported that their full council had been ‘very engaged’ in their STP.

The LGA is calling for the NHS to involve councillors as equal partners in STPs.

NHS England announces new ambulance standards

NHS England has announced it will be implementing new ambulance standards across the country to update a system which has been in place for decades. The change focusses on enduring the best, high quality, most appropriate response is provided for each patient first time.

The change will introduce four categories of calls:

  1. calls from people with life-threatening illnesses or injuries;
  2. emergency calls;
  3. urgent calls; and
  4. less urgent calls.

NHS England has published four short animations which explain each of the categories in more detail.

State of Caring 2017

Carers UK has published the annual State of Caring report, based on a survey of over 7,000 responses from carers sharing their experiences – the largest number of responses to date.

Key facts identified in the report include:

  • 69% of carers said they find it difficult to get a good night’s sleep because of their caring role;
  • 68% said that their GP knows they are a carer but that they don’t do anything different as a result;
  • 40% said they hadn’t had a day off from caring for more than a year, and for 25% this was the case for more than five years; and
  • in order to make ends meet, carers had been forced to use either their savings (30%), credit cards (26%) or bank overdrafts (23%).

The report features a series of recommendations for measures relating to carers’ finances, careers, breaks and building a ‘Carer Friendly NHS’.

Annual diabetes checks reduce mortality risk for people with diabetes

NHS Digital has published an article highlighting that according to the National Diabetes Audit 2015/16, people with diabetes who have had annual – diabetes checks regularly in the preceding seven years have a mortality rate half of those who haven’t.

Key facts highlighted from the audit include:

  • for people with Type 1 diabetes, the additional risk of death was 127.8% higher than the wider population and for Type 2 diabetes it was 28.4% higher;
  • 2% of all emergency and non-emergency hospital admissions for cardiovascular conditions were for people with diabetes; and
  • vascular outcomes accounted for a higher proportion of deaths among people with diabetes.

Children’s Commissioner’s report on vulnerability

The Children’s Commissioner for England has published a new analysis which brings together a range of information held by various government departments and agencies on child vulnerability.

Key facts in the report include:

  • at the end of March 2016, there were 394,400 children in need;
  • at the end of 2016, 121,000 young people aged 16-18 years old were not in education, employment or training;
  • in 2016, there were 36,000 teenage mothers aged 19 years and under living with their children;
  • in 2016, 11,624 children under 18 years old were living with adults in drug treatment;
  • at the end of December 2016, 118,960 children were homeless or were in temporary accommodation; and
  • in 2015 there were 171,024 young children aged 5 to 17 years old who were unpaid carers.



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