Health & Care Review

Health & Care Review

February 26, 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.

Review launched to respond to patient concerns about NHS treatments

The Department of Health and Social Care (DHSC) has announced a review which will focus on three NHS treatments: Primodos (a hormone pregnancy test used up until 1978), vaginal mesh implants and sodium valproate.

The review will look at whether further action is needed and how the health system responds to reports from patients about side effects from treatments.

Health and Social Care Secretary Jeremy Hunt said “Over the years, there have been significant concerns raised by individuals and campaign groups about the potentially harmful effects of 3 products used by the NHS. The response they have received from those in positions of authority has not always been good enough.”

PRAC recommends new measures to avoid valproate exposure in pregnancy

The European Medicines Agency’s Pharmacovigilance Risk Assessment Committee (PRAC) has issued recommendations on new measures to avoid valproate exposure in pregnancy.

The recommendations include the implementation of a new pregnancy prevention programme, which involves:

  • assessing patients for the potential of becoming pregnant and involving the patient in evaluating her individual circumstances and supporting informed decision making;
  • pregnancy tests before starting and during treatment;
  • counselling patients about the risks;
  • explaining the need for effective contraception throughout treatment;
  • carrying out reviews of treatment by a specialist at least annually; and
  • introduction of a new risk acknowledgement form that patients and prescribers go through at each such review to confirm that appropriate advice has been given and understood.

Making sense of integrated care systems, integrated care partnerships and accountable care organisations in the NHS in England

The King’s Fund has updated an article it had previously published, in light of NHS England’s decision to change the name of accountable care systems (ACOs) to integrated care systems (ICSs). The updated article looks at work underway in these systems and at NHS England’s proposals for an ACO contract.

The briefing provides a definition of the three main forms of integrated care, what is happening with new models of care, what they have achieved and what it means for commissioning.

The article concludes that:

  • developments will not deliver results quickly which is why national and local leaders need to make a long-term commitment to developing integrated care as the main way of providing and funding care in the future. Integrated care is not a panacea and unless implemented with skill it will not deliver the improvements in health and care envisaged in the Forward View.
  • operational pressures cannot be managed simply by working harder; they require the development of new care models better able to meet rising demand for care in the community as well as hospitals.

Life Expectancy: Is the Socio-Economic Gap Narrowing?

The Longevity Science Patel has published a report based on the findings of a review it conducted on mortality trends of people between different socio-economic circumstances in England.

Key findings include:

  • differences in life-expectancy between the rich and poor in England have widened between 2001 and 2015;
  • death rates have fallen faster for the richer between 2001 and 2015; and
  • income deprivation, as estimated from state benefits and largely associated with unemployment, is the strongest independent predictor of mortality rates in a neighbourhood.

A Royal Commission on the NHS: The remit

The Centre for Policy Studies has published a report based on Lord Saatchi’s proposal for a Royal Commission to safeguard the NHS.

The report, by Lord Saatchi and Dominic Nutt sets out the remit and priorities that such a commission should adopt in order to address the NHS’s most pressing issues. It sets out how a Royal Commission can ensure the NHS delivers the best outcomes on a sustainable financial basis over the coming decades.

Quarterly performance of the NHS provider sector: quarter 3 2017/18

NHS Improvement has published a report which describes the performance of the NHS provider sector for the month ending 31st December 2017.

Key facts include:

  • Rising demand and high levels of bed occupancy have affected providers’ ability to admit patient who require planned care; during Quarter 3 there were around 470,000 bed days across acute, community and mental health providers occupied by delayed discharge patients (accounting for 4.6% of all beds);
  • agency costs have continued to decrease significantly and despite an increase in bank staff, the sector spent £108 million less than planned on agency staff and £441 million less than the same period last year, a fall of 20%; and
  • included in the report for the first time is workforce data from providers, which shows that they employ 1.1 million whole time equivalent staff but that they have 100,000 vacancies.

Mapping of specialist primary health care services in England for people who are homeless

King’s College London has published a report detailing key findings from a systematic mapping exercise across England of specialist primary health care services for single people who are homeless.

The mapping exercise was part of a larger study in progress which is examining the integration, effectiveness and cost-effectiveness of different models of delivering primary health care to people who are homeless (HEARTH study).

Prevalence and economic burden of medication errors in the NHS in England

A new piece of research has been published which forms a rapid review to identify literature about the incidence and prevalence of medication errors in the UK, their associated costs and health burdens, and to provide a model on annual national estimates on NHS England.

This research was funded by the UK Department of Health Policy Research Programme through its Policy Research Unit in Economic Evaluation of Health & Care Interventions (EEPRU). EEPRU is a collaboration between researchers from two institutions (Centre for Health Economics, University of York and School of Health and Related Studies, University of Sheffield). This research also involved the University of Manchester.

Key facts include:

  • there is an estimated 237 million medication errors that occur at some point in the medication process in England per year. It is likely that many errors are picked up before they reach the patient, but we do not know how many;
  • the estimated NHS costs of definitely avoidable adverse drug reactions (ADRs) are £98.5 million per year, consuming 181,626 bed days, causing 712 deaths, and contributing to 1,708 deaths;
  • error rates in the UK are similar to those in other comparable health settings such as the US and other countries in the EU;
  • non-steroidal anti-inflammatory drugs, anticoagulants and antiplatelets cause over a third of admissions due to avoidable ADRs and;
  • future work should focus on improving routine collection of information about errors and patient harm, and supporting implementation of evidence-based interventions to reduce errors.

Clearing up some myths around e-cigarettes

Public Health England (PHE) has published an article which looks at some common myths around the use of e-cigarettes and provides the facts. PHE’s latest comprehensive independent e-cigarette review looks at the up-to-date international data and peer-reviewed research.

The general conclusion is that while not without some risk, when compared to smoking e-cigarettes are far less harmful.

Cancer Research UK to invest £45 million in clinical trials

Cancer Research UK has announced that £45 million will be invested into its network of clinical trials units across the UK, one of the charity’s largest investments in clinical research to date.

The fund will be divided over five years across eight clinical trials units in Cardiff, Birmingham. Glasgow, Southampton, Leeds and London.

Media monitoring

On Tuesday 20th February 2018, the following stories were published:

  • The Times reports that parents who refuse to vaccinate their children led to cases of measles increased by 300% across Europe last year. But all of the 282 reported cases in Britain were caused by people arriving from affected countries. The story was also covered by The Guardian, who put the increase in cases of measles in Europe at 400%.
  • The Independent reports that only 34% of women would visit their GP about unexplained bloating, with many instead simply changing their diet. The research was run by the charity Target Ovarian Cancer which is concerned about a lack of awareness of the key warning signs. This story was also covered by The Times, The Express, The Mirror and the BBC.
  • A third of Brits are significantly underestimating the number of calories they consume each day, reports the BBC. This story was also covered by iNews, The Guardian, The Daily Mail, The Sun and Sky News.

On Wednesday 21st February 2018, the following stories were published:

  • Chronic heavy drinking may be a major risk factor for early-onset dementia, reports iNews, the SunDaily MailTelegraph, and Times.
  • A study looking at the impact of low carb and low fat diets has found that both can work and that weight loss is influenced by healthy eating rather than genetic factors. This was reported in the Guardian, iNews and Telegraph.
  • The Daily Mail reports on a study which suggests that stress in early life could lead to inflammation that affects immunity and overall health in later life.

On Thursday 22nd February 2018, the following stories were published:

  • The British Heart Foundation says that progress in reducing premature heart attack deaths has stalled, as reported in iNews.
  • A Lancet study which analysed data from 522 trials has concluded that 21 common anti-depressants are all more effective at reducing symptoms of acute depression than placebos. This was reported by the BBCGuardianTelegraphTimes and the Independent.

On Friday 23rd February 2018, the following story was published:

  • Sipping fruit teas and hot water with lemon can leave people 11 times more likely to suffer tooth erosion, report the Mirror, the BBC and the Express.

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