Health & Care Review
Health & Care Review
February 13, 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.
The progress of health and social care integration
The National Audit Office has published a report which analyses the progress that the Department of Health, the Department for Communities and Local Government and NHS England have made towards integrating health and social care services.
The report covers the case for integrating health and social care systems, progress with national initiatives, including the first year of implementation of the Better Care Fund (BCF), and the Departments’ plans for increased integration.
Key findings include:
- nearly 20 years of initiatives to join up health and social care by successive governments has not led to system-wide integrated services;
- the Departments have not yet established a robust evidence base to show that integration leads to better outcomes for patients;
- nationally, the BCF did not achieve its principal financial or service targets over 2015/16, its first year;
- NHS England’s ambition to save £900 million through introducing new care models may be optimistic; and
- NHS England is diverting resources away from long-term transformation to plug short-term financial gaps.
NHS England, Government and BMA agree new GP contract for 2017/18
NHS England, the Government and the British Medical Association (BMA) General Practitioners Committee have agreed on changes to the general practice contract in England for 2017/18 with an investment of approximately £238.7 million.
The changes include:
- an increase in the payment for the Learning Disabilities Health Check Scheme;
- practices will use an appropriate tool to identify patients aged 65 and over who are living with moderate and severe frailty. For those patients identified as living with severe frailty, the practice will deliver a clinical review providing an annual medication review and where clinically appropriate discuss whether the patient has fallen in the last 12 months and provide any other clinically relevant interventions; and
- prisoners will be able to register with a practice before they leave prison.
Non-contractual changes include:
- an increased uptake of electronic repeat prescriptions to 25% with reference to co-ordination with community pharmacy;
- continued uptake of electronic repeat dispensing with reference to CCG use of medicines management and co-ordination with community pharmacy; and
- better sharing of data and patient records as local level, between practices and between primary and secondary care.
Emerging evidence on the NHS Health Check: findings and recommendations
Public Health England has published a new briefing showcasing the findings of a report by the NHS Health Check Expert Scientific and Clinical Advisory Panel on emerging evidence of the NHS Health Check and recommendations for practice and research. The report is based on an evidence synthesis completed by the University of Cambridge and RAND Europe.
The evidence synthesis sought to answer the six questions below:
- Who is and who is not having an NHS Health Check?
- What are the factors that increase take-up among the population and sub-groups?
- Why do people not take up an offer of an NHS Health Check?
- How is primary care managing people identified as being at risk of CVD or with abnormal risk factor results?
- What are patients’ experiences of having an NHS Health Check?
- What is the effect of the NHS Health Check on disease detection, changing behaviours, referrals to local risk management services, reductions in individual risk factor prevalence, reducing CVD risk and on statin and antihypertensive prescribing?
Recommendations for actions relate to NHS Health Check coverage, take-up, patients’ perspectives, professionals’ perspectives, the programme’s impact and research.
The briefing refers to qualitative research that indicates that being able to access a check at a convenient time and in a familiar location can increase people’s willingness to take up the offer of a check. In particular, it seems that some people consider pharmacies, community settings or workplaces as being more convenient to access than general practice. Others, however, report anxieties about the competence of staff, privacy and confidentiality of having an NHS Health Check in these locations.
Preventing falls in older people through conversation
The National Institute for Health and Care Excellence (NICE) has updated their quality standard on reducing falls in older people.
The new additions cover identifying people at risk of falling, multifactorial risk assessment for older people at risk of falling and multifactorial intervention. NICE is calling for people aged 65 years and over to be regularly asked questions about whether they have fallen over in the last year or feel unsteady on their feet.
Professor Gillian Leng, deputy chief executive at NICE, said: “Asking older people about falls on a regular basis will identify those who are most at risk. Through this simple intervention, those people can then be referred to the right health care professional or service to stop them falling in the future.”
NICE seeks to support new mothers with mental health problems
NICE has suggested that new mothers should be asked about their mental health at the routine six-week postnatal appointment to identify those at risk of mental health problems and to help vulnerable people get the correct diagnosis and support.
Some common symptoms such as changes to appetite or sleeping patterns, could be symptoms of mental health problems but are masked by what is considered as normal for pregnant and postnatal women.
This suggestion, among others, are being consulted on as part of NICE’s draft indicator menu.
What’s behind delayed transfers of care?
The Nuffield Trust has published a briefing exploring delayed transfers of care and provides some thoughts on solutions to prevent them.
The briefing also includes two charts which show how the number of delayed days across the NHS by organisation has grown since December 2010 and the percentage change in days transfers of care delayed by cause from 2010/11 to 2015/16.
Key facts include:
- between 2011/12 and 2014/15, the number of bed days used by patients who were delayed grew by 60%;
- NHS England had remained responsible for the majority of delayed transfers of care cases over time, but the proportion for which social care are responsible has grown by 84% since December 2010; and
- the most significant change since November 2010 has been an increase in the number of days delayed due to patients waiting for a care package to be available either at home (172% increase) or in a nursing home (110%).
New MedRegs blog
The Medicines and Healthcare products Regulatory Agency (MHRA) has launched a new official blog which provides insight into developing and submitting applications to the MHRA for marketing authorisations and clinical trial authorisations.
Topics to be covered are:
- submissions – how to get them right first time;
- behind the scenes – find out more about how the regulator works; and
- key issues – the inside track on emerging issues for the regulation of medicines.
Working with faith groups to promote health and wellbeing
The Local Government Association has published a briefing which suggests how LAs can work with faith groups to positively impact the health of their members and wider communities.
The briefing covers how faith groups can improve health outcomes and tackle health inequality, barriers to collaboration and suggestions for how effective partnerships and activity can be established.
Some of the main ways in which faith groups can have a positive impact on health and wellbeing include:
- support for ethnic groups who face health inequalities or are at greater risk of developing specific health problems;
- social action to improve the lives of people who face problems such as poverty or homelessness; and
- articulating the health needs of their communities.
The briefing features case studies of different areas who have had some success in engaging with faith groups.