Health & Care Review

Health & Care Review

August 7, 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.

Naloxone survey 2017

The Local Government Association (LGA) has published the results of a survey conducted by the LGA’s Research and Information team on behalf of the LGA and Public Health England (PHE).

The survey took place between mid-June and early July 2017 to better understand the use of naloxone across local authorities (LAs).

Key findings from the survey include:

  • 90% of respondent LAs made available take-home naloxone;
  • 99% of respondents who have made it available did so via drug treatment services, 25% did so via hostels and 25% using outreach workers; and
  • 50% of respondents who did not make it available (14) indicated that they would make it available if there was an increase in opiate overdoses or drug-related deaths in their area.

Hexavalent 6-in-1 vaccine to be made available to newborn babies

PHE has announced that instead of the existing 5-in-1 vaccine that children routinely receive at birth, all babies born on or after 1st August 2017 will be offered a hexavalent 6-in-1 vaccine to include protection against the hepatitis B virus.

There will be no changes to the vaccines or immunisation schedule at the ages of 8, 12 and 16 weeks.

Mary Ramsay, Head of Immunisation at Public Health England said: “Until today, only children at high risk of hepatitis B would be immunised. The introduction of hexavalent vaccine means that all children will now be routinely protected against this serious infection, which is a major cause of cirrhosis and liver cancer in later life. The hexavalent vaccine has been extensively tested and shown to be safe and is widely used internationally with millions of doses being given around the world.”

Health Profiles: August 2017 data update

PHE has published its quarterly update for the online Health Profiles for August 2017. This update features one new indicator showing the estimated dementia diagnosis rate for people aged 65 years and over.

Key statistics in the updated profiles include:

  • in 2016, of all adult survey respondents in England, 15.5% smoked which equates to around 6.7 million in the population;
  • the rate of new sexually transmitted infections in those aged 15 to 64 for England decreased significantly between 2015 to 2016, from 833 to 795 per 100,000 population aged 15 to 64); and
  • it is estimated that just over two thirds of cases of dementia had been diagnosed in England in 2017.

Public health outcomes framework: August 2017 data update

The Public Health Outcomes Framework has been updated for August 2017 and published by PHE. This update contains more recent data for some indicators, equalities or inequalities breakdowns for two indicators and changes to two indicators to account for revisions to the underlying data or the methods used.

Key statistics in the update include:

  • in the last four years, nearly 75% of the eligible population have been offered an NHS Health Check with just under half receiving one;
  • in 2016, over 1.4 million chlamydia tests were carried out in England among young people aged 15 to 24 years; and
  • vaccination coverage increased in 2016/17 for those aged two to four years and those in clinical at-risk groups. However, for those aged 65 and over, coverage fell.

Dementia in older age: barriers to primary prevention and factors

PHE has published an evidence review and other publications relating to dementia aimed at commissioners and researchers to help them make decisions about preventative measures.

The review was conducted by the Personal Social Services Research Unit at the London School of Economics and Political Science and highlights the various factors that increase the risk of dementia.

The documents highlight that to promote the primary prevention of dementia, it is important to understand both the barriers to primary prevention and factors which facilitate primary prevention.

Key messages from the reviews are:

  • around one-third of cases of dementia in old age could be potentially prevented through changes in mid-life behaviour;
  • although the evidence is fairly limited, there is sufficient evidence to show that a range of behaviours in mid-life impact on the risk of dementia in later life;
  • there is evidence that physical inactivity, current smoking, diabetes, hypertension in mid-life, obesity in mid-life and depression increase the risk of dementia and that mental activity can reduce the risk of dementia;
  • there is currently insufficient evidence that alcohol, diet, mental distress, social isolation, loneliness or air pollution affect the risk of dementia in later life; and
  • further research is also required to better understand the relationship between the mid-life risk factors and dementia.

Implementation guide and resource pack for dementia care

NHS England has published a guide which sets out details for the transformation of dementia care and its relevance to commissioners, providers and Sustainability and Transformation Partnerships (STPs) in supporting the delivery of a number of objectives in the Department of Health’s Prime Minister’s challenge on dementia 2020.

It provides guidance and information on:

  • the policy and strategic context for transforming dementia care;
  • access and quality benchmarks for the dementia care pathway;
  • how to deliver high-quality dementia care; and
  • collecting data and measuring outcomes.

CCG improvement and assessment framework 2016/17

NHS England has published the Clinical Commissioning Group (CCG) improvement and assessment framework 2016/17 which replaces the CCG assurance framework and CCG performance dashboard.

The framework aligns key objectives and priorities within the NHS Five Year Forward View, NHS Planning Guidance and STPs. It has been designed to supply indicators for adoption in STPs as markers of success.

The new framework has been constructed to cover indicators located in four domains:

  1. Better Health: this section looks at how the CCG is contributing towards improving the health and wellbeing of its population, and bending the demand curve;
  2. Better Care: this focusses on care redesign, performance of constitutional standards, and outcomes, including in important clinical areas;
  3. Sustainability: this section looks at how the CCG is remaining in financial balance and securing good value for patients and the public from the money it spends; and
  4. Leadership: this domain assesses the quality of the CCG’s leadership, the quality of its plan and how the CCG works with partners.

Improving access for all: reducing inequalities in access to general practice services

NHS England has published a resource on how to identify and address barriers to general practice to allow improved access to the full range of services offered.

The guide provides information on understanding local populations and why patient and public involvement is important. It also illustrates the key factors influencing a patient’s ability to access GP services in England and provides ideas and innovations to increase capacity and improve access for all.

10-point plan sets out actions to deliver General Practice Nursing workforce for the future

NHS England has launched a 10-point action plan to develop the roles of general practice nurses (GPNs) to transform and improve patient care. The plans are attached to an investment of £15 million to help target and prioritise where improvements are needed most.

The plans include measures to:

  • increase uptake and promote nursing in general practice;
  • support for existing GPNs; and
  • encouraging GPNs to return to practice.

GP Forward View Annual Assessment

The Royal College of General Practitioners (RCGP) has published the first annual assessment of implementation of the General Practice Forward View (GPFV).

The RCGP publication provides a summary of progress on the key commitments of the GPFV. It concludes that despite the beginnings of some promising programmes and overall investment, progress is still too patchy and several commitments are not yet being delivered.

The RCGP also offers specific recommendations relating to the progress of individual commitments and are categorised as areas to rethink; improve; deliver; communicate; expand; or continue.

Thousands of new roles to be created in mental health workforce plan

Health Secretary Jeremy Hunt has launched a plan to expand the mental health workforce developed by Health Education England (HEE) and its NHS partners, the Royal College of Psychiatrists and other mental health experts. The plan has been allocated £1.3 billion by the Government to transform mental health services.

The plan shows how the health service will increase the number of trained nurses, therapists, psychiatrists, peer support workers and other mental health professionals to equalise workplace capacity.

The Government has made a pledge to:

  • treat an extra one million patients by 2020/21;
  • provide services seven days a week, 24 hours a day; and
  • integrate mental and physical health services for the first time.

New framework to promote person-centred approaches in healthcare

HEE has launched a new framework to support person-centred approaches for the health and social care workforce. It aims to distil best practice and set out the core transferable behaviours, knowledge and skills required, applicable across different services and sectors. It also articulates what it means to be person-centred and how to develop and support the workforce to work in this way.

The framework is structured such that it describes the behaviours, knowledge and skills to implement person-centred approaches in three steps:

  1. conversations to engage with people;
  2. conversations to enable and support people; and
  3. conversations with people to collaboratively manage highest complexity and significant risk.

Within each step, the framework provides behaviours and learning outcomes.

Increase in prescriptions for diabetes exceeds rise in overall prescribing

NHS Digital has published figures which show that prescription items for the treatment of diabetes in primary care have increased by 80.1% over the last decade, compared with a 46% rise across all primary care prescribing.

The report, Prescribing for Diabetes: England 2006/07 to 2016/17 shows that 52 million items were prescribed for diabetes in 2016/17, compared to 49.7 million in 2015/16 and 28.9 million in 2006/07.

Key facts in the report are:

  • drugs used in diabetes (those listed in the British National Formulary (BNF) section 6.1) now make up 11% of the total primary care net ingredient cost (NIC) and 4.7% of prescription items;
  • in the financial year 2016/17 there were 52 million items prescribed for diabetes at a total NIC of £983.7 million. This is an increase from 28.9 million prescription items and £572.4 million in 2006/07; and
  • antidiabetic drugs (BNF section 6.1.2) make up 45.1% of the total £983.7 million NIC of drugs used in diabetes and accounts for 72% of prescription items for all diabetes prescribing.

Personal Social Services Survey of Adult Carers in England, 2016/17

A survey on adult carers has been conducted by Councils with Adult Social Services Responsibilities, the findings of which have been published by NHS Digital.

The survey seeks the opinions of carers aged 18 years or over, caring for a person aged 18 years or over, on different topics that are considered to be indicative of a balanced life alongside their unpaid caring role.

Key facts highlighted in the survey include:

  • 71% of carers who received support or services were extremely, very or quite satisfied with the support or services they received;
  • 1% of carers aged 85 and over have caring responsibilities for someone aged 75 years or over;
  • of carers who have had a lot of financial difficulties caused by their caring responsibilities, 38.7% report having little social contact with people and feeling socially isolated;
  • 5% of carers spend more than 35 hours per week providing care; and
  • 7% of carers provide care for over 100 hours per week.

Sexual health services at tipping point, warn councils

The LGA has published an article warning that sexual health services are at a tipping point due to increasing demand for the services.

It highlights that in 2016, there were 2,456,779 new attendances at sexual health clinics compared to 1,941,801 in 2012. The LGA says the cuts to public health budgets of £531 million, a reduction of nearly 10%, by the Government has meant that LAs are struggling to keep up with the increased demand.

Councillor Izzi Seccombe, Chairman of the LGA’s Community Wellbeing Board, said: “While it is encouraging that more and more people are taking their own and their partners’ sexual health seriously, we are concerned that this increase in demand is creating capacity and resource issues for councils.

We are concerned that this will see waiting times start to increase and patient experience deteriorate.

The reduction in public health funding could also compound problems further and impact on councils’ ability to meet demand and respond to unforeseen outbreaks…”

Deaths related to drug poisoning in England 2016

The Office for National Statistics has published a report on deaths related to drug poisoning in England and Wales from 1993 onwards, by cause of death, sex, age and contributing substances.

Main points highlighted in the report include:

  • there were 3,744 drug poisoning deaths involving both legal and illegal drugs; this is an increase of 2% from 2015 and the highest number since 1993;
  • 69% of those deaths were drug misuse deaths;
  • people aged 40-49 years had the highest rate of drug misuse deaths in 2016, overtaking those aged 30-39 years; and
  • 54% of all deaths related to drug poisoning in 2016 involved an opiate (mainly heroin and/or morphine).

In light of these statistics, the Royal Society for Public Health (RSPH) has urged the Government to reverse cuts to LA public health budgets and invest in pragmatic harm reduction measures.

RSPH also highlights that the UK retains a drug death rate almost three times higher than the European average.



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