Health & Care Review

Health & Care Review

April 13, 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.

Accountable care models contract: proposed changes to regulations

The Department of Health and Social Care (DHSC) has published the full outcome of a consultation which took place between September and November 2017 on the proposed changes to regulations to support the development of NHS England’s Accountable Care Organisation (ACO) contract model. The consultation specifically asked consultees to consider whether the draft regulations delivered the policy objective of the introduction of a model ACO contract.

The full outcome report sets out specific issues raised, an analysis of the responses received, a response to concerns raised, and changes made to draft amendments as a result of comments received.

DHSC has also published an accompanying brief guide to ACOs which covers what they are, what they mean for patients and staff, how they will be implemented and whether or not they will lead to more private sector involvement in the NHS.

One in six people with diabetes discriminated against at work

Diabetes UK has published research findings which highlight that a third of people living with diabetes experience a lack of support and understanding from colleagues in the workplace. Additionally, people with diabetes feel that they have been discriminated against by their employer as a result of their condition.

The survey also found that:

  • 37% of respondents said that living with diabetes had caused them difficulty at work;
  • 7% had not told their employer that they have diabetes; and
  • 25% of people said they would like time off work for diabetes-related appointments and flexibility to take regular breaks for testing their blood sugar or to take medication.

Helen Dickens, Assistant Director of Campaigns and Mobilisation at Diabetes UK, said: “Discrimination and difficulties come about because employers lack knowledge about diabetes and do not understand its impact. We need to talk more about the condition and the many ways it affects people’s lives in order to persuade places of work to offer greater understanding and flexibility. Everyone deserves to work in an environment where they can ask for the support they need.”

Dedicated GP support for nursing homes sees significant drop in emergency admissions

The Nuffield Trust has published a study which evaluates a new GP service offering seven-day support to four nursing homes. The service was piloted in the Barking & Dagenham and Havering & Redbridge Clinical Commissioning Groups (CCG) and involves providing GP support as well as training and advice for care home workers and help from a geriatrician.

Key facts from the evaluation include:

  • after registering with the service, emergency inpatient admissions fell by 36% compared to 4% reductions in the comparator group;
  • the authors estimate that the monetary value of reductions in emergency admissions could be as much as £1000 per person per year, but that this is not necessarily directly equivalent to actual cash savings for either commissioners or providers;
  • emergency bed days in the intervention group reduced by 53% compared to no change in the comparator group; and
  • the biggest reductions in emergency admissions and bed days happened towards the end of people’s lives.

The success of the new primary care service in care homes in general, the report authors suggest, depends on the quality and continuity of relationships developed between the GPs and the care homes.

RCGP advises patients on online consultation safety

The Royal College of General Practitioners have issued a list of questions for patients, GPs and commissioners to consider before using online GP services, as part of a new guidance document, Online consultations in general practice: the questions to ask.

The guidance has been issued as it emerged that a growing number of services are offering consultations online, most commonly via smartphone apps.

The questions are:

  1. Will they see me whatever my health problem, or exclude me if I have complex health needs?
  2. Will they have access to my full medical record, so that they know my medical history?
  3. What happens if I need to see a GP in person – how far will I need to travel?

The guidance also outlines considerations for GPs or CCGs considering using or implementing online consultation services for their patients or local populations.

New funding for sports prosthetics for children with disabilities

The Government has announced that children with limb loss will benefit from a new £1.5 million investment into sports and activity prosthetics such as running blades. The fund will also support research and innovation to improve prosthetic technology.

PM announced new research and funding in drive to fight prostate cancer

The Prime Minister has unveiled new plans to get thousands of men with prostate cancer access to earlier and faster treatment. Over the next five years, over 40,000 men will be recruited into prostate cancer studies backed by £75 million funding.

22 Million people encouraged to embrace self care for life

The Self Care Forum has published a review of Self Care Week 2017 as well as findings from a survey of participants of the campaign. The 2017 theme of Embracing Self Care for Life allowed promotion of a range of self-care messages, supported by a range of resources for people-facing organisations.

The review found that more than 300 organisations participated in the campaign, with a combined reach of more than 22 million people – more than a third of the English population.

The survey found that self-care for self-treatable conditions was the most popular message being communicated, and signposting to the community pharmacist was the second most favoured.

Review into NHS overseas visitor charges: call for submissions

DHSC is evaluating the impact of its regulations on NHS charges to overseas visitors that came into effect in 2017 and is asking organisations to share information or experiences to help shape the review.

The review will look at the impact on: upfront charging; amending patient records; community services; and non-NHS providers. It will focus on the impact on vulnerable groups (such as those with protected characteristics) and how any identified negative effects can be addressed.

Does the public see tax rises as the answer to NHS funding pressures?

The King’s Fund has analysed the latest data from the British Social Attitudes survey on public attitudes to NHS funding and the quality of care provided by the NHS. In general, the analysis shows that the public is increasingly anxious about the state of the NHS and there is widespread support for tax increases to fund it.

Key findings include:

  • there is growing consensus that the NHS is facing major crisis; respondents saying that the NHS is facing a funding problem have increased by 14% since 2014;
  • 61% of respondents support tax rises; an increase of 21% from 2014 and 12% from 2016;
  • in relation to tax increases, 35% supported a separate tax that would go direct to the NHS and 26% would pay more through their existing taxes; and
  • pessimism about the future has increased significantly; just 20% expected standards of care to improve.

Patient Activation Measure – implementation quick guide

NHS England has published a quick guide on Patient Activation Measures (PAM) to support sites considering using the PAM license.

The guide covers preparatory work, how to ensure good quality data and how the PAM can ensure that plans for services and support are tailored to an individual’s needs. It also focusses on why patient activation is important in managing people’s health and wellbeing.

Media monitoring

On Monday 9th April 2018 the following stories were published:

  • Tens of thousands of allergy patients face ‘life or death situations’ because of a UK shortage of EpiPen jabs, reports the Mail. US manufacturer Mylan has warned pharmacists and patients in Britain that the country is the latest to be hit by global supply problems. Also featured in the Telegraph and Sun.
  • British tourists will be putting their health at danger when the NHS axes travel vaccinations for rabies and yellow fever, reports the Mail. Experts believe the change could lead to an increase in people obtaining the vaccines via a private prescription and attempting to self-administer to save costs.
  • Four in ten prostate cancer cases diagnosed late, reports the BBC. A study by charity Orchid found a ‘worrying trend’ of late diagnosis with 37% of prostate cancer cases diagnosed at stages three and four. Also featured in the Times, Sun, Mail and Huffington Post.

On Tuesday 10th April 2018 the following stories were published:

  • Deceased organ donor numbers have reached a record high, reports iNews. Latest figures show there were 1,575 deceased donors during 2017/18, an 11% increase on the previous year. A new Bill which would introduce the opt-out system in England passed its first stage in Parliament in February. Also featured in the Times, Mirror, Sun, Huffington Post and the BBC.
  • Patients aged over 60 who lose weight should be investigated, reports the Telegraph. One in seven cases among men likely to mean cancer, a major study has found. Also featured in the Sun, Mail, Times and Express.

On Wednesday 11th April 2018 the following stories were published:

  • The Times reports elderly patients effectively age 10 years for every 10 days they are stuck in a hospital bed due to inactivity. This has also been covered by The Telegraph and The Mail.
  • The Guardian reports that two-fifths of private hospitals in England fail to meet the expected safety standards, according to the Care Quality Commission. This is of concern not just to private patients, but also those given NHS funding to be seen privately. Also covered by iNews, the Independent, Times and BBC.
  • Pfizer UK have a piece in The Telegraph about access to medicines in the NHS. It’s largely focused on treatments for cancer and vaccines.
  • The Sun warns that a new killer flu strain is on its way, but the World Health Organisation has said it will be included in this year’s four-strain flu vaccine.

On Thursday 12th April 2018 the following stories were published:

  • The Telegraph reports that the NHS has launched a sexual abuse probe amid fears of dangers on mixed sex wards. Inspectors have warned hospital trusts to do more to protect patients, amid fears patients are being put at risk on mixed sex wards.
  • iNews reports that a 50% rise in cigarette prices ‘will save millions of poorer people’.
  • A new study suggests that a substantial increase in cigarette prices would help millions of people around the world avoid poor health and extreme poverty. Also featured in the Sun, Mail and Telegraph.
  • Late risers at increased risk of early death, reports the BBC. People who go to bed late and struggle to wake in the morning are more likely to die prematurely than early risers, according to new research. Also featured in the Telegraph.

On Friday 13th April 2018 the following stories were published:

  • The Sun discloses the NHS’s ten worst-performing A&E wards. Following the announcement that A&E waiting times are at their worst level since records began, the ten worst offenders have been revealed. Similar stories are featured in the Mail, ITV, Express and Times.
  • Just one alcoholic drink a day could shorten your life, reports the BBC. An analysis of 600,000 drinkers found that drinking 5 to 10 alcoholic drinks a week was likely to shorten a person’s life by up to six months. Also featured in the Express, Evening Standard, Independent and Telegraph.

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