Health & Care Review

Health & Care Review

September 5, 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.

New additional section to Health & Care Review – Media monitoring

As part of PSNC’s ongoing work to help contractors and LPCs stay up to date on what is going on in the wider health and care landscape beyond community pharmacy, a new section has been added to the PSNC weekly Health and Care Review called ‘Media monitoring’. In this section, we will highlight a selection of the main health related stories that have been published in the national media during the week.

Nasal spray effective at protecting vaccinated children from flu

Public Health England (PHE) has published new data which shows that the flu vaccine nasal spray reduced the risk of vaccinated children getting flu by 65.8% during 2016/17 in England, Wales, Scotland and Northern Ireland.

Other facts included in the data include:

  • effectiveness of flu vaccine in younger vaccinated adults aged 18 to 64 years reduced the risk of flu by 40.6% during 2016/17;
  • in 2016/17, PHE did not find that the vaccine was significantly effective in protecting against influenza for the over 65s; and
  • the lower effectiveness in the older population this season highlights the need to continue to expand the programme among the young, as by protecting them, this also indirectly protects those at high-risk of flu.

Jenny Harries, Deputy Medical Director for PHE said: “It is good news that last winter children were particularly well protected against flu with the vaccine nasal spray. We know children can spread flu more than others and if we can keep them well it means that the infection is less likely to pass to those who are at high risk. We also saw the risk of flu fall by over 40% in vaccinated adults under 65 allowing more people to stay well last winter.”

Sexual health, reproductive health and HIV: commissioning review

PHE and the Association of Directors of Public Health, supported by NHS England and NHS Clinical Commissioners have published a report highlighting the findings of a survey of local authorities (LAs), Clinical Commissioning Groups (CCGs) and NHS England.

The survey, carried out in 2016, looked at the variability in implementation of the commissioning arrangements introduced for sexual and reproductive health and HIV to provide a clear picture and highlight areas of challenges within the commissioning framework.

There were six key themes that were consistently found within the survey responses:

  • fragmentation of commissioning;
  • ensuring access to services, particularly for those at greatest risk;
  • contracting problems including cross-charging for patients attending services outside of area;
  • workforce concerns – clinical expertise both in service delivery but also in commissioning;
  • increasing demand for some services; and
  • financial pressures due to reductions in budgets – particularly in LAs.

Stocktake of local mental health prevention planning arrangements

PHE has published a high-level summary of how the promotion of mental health and prevention of mental ill-health is incorporated in planning processes in local areas. The research was undertaken by the King’s Fund and commissioned by PHE and looked at 35 local areas.

Key findings include:

  • all 35 local areas had included promotion of mental health and/or prevention of mental health problems in their planning processes to some degree;
  • the overall level of priority given to this varied significantly between sites; and
  • there was also variation within sites, with different stakeholders placing greater emphasis on different levels of prevention.

NHS hospitals deeper in the red than reported, new report claims

The Nuffield Trust has published a new briefing showcasing the state of the NHS’s finances and outlines the prospects for the next three to four years.

It analyses the accounts and financial data published by NHS regulators and warns that although trusts have repeatedly delivered large efficiencies, in recent years they have been relying increasingly heavily on one-off savings and paper-based savings from accountancy changes.

Key findings in the briefing include:

  • even if trusts continue to make savings at a relatively high rate historically, they will still run up underlying deficits for the foreseeable future and will remain more than £2 billion in the red, in underlying terms, in 2021. This underlying deficit could be as high as £3.7 billion if inflation continues to rise faster than NHS regulators anticipated;
  • NHS commissioners, the bodies responsible for passing on funding to trusts, will not have any room to give them more money due to their own budgets being squeezed; and
  • the proportion of commissioners’ funding which goes to hospital and other specialist care is set to rise from 63% to 65% in 2020, even though the NHS is supposed to be reforming itself to rely less on hospitals.

Reducing health inequalities in local areas

PHE has published a document, Reducing health inequalities: system, scale and sustainability, which aims to support local action to tackle health inequalities. It helps local partners identify what specific interventions could measurably improve outcomes. It is also accompanied by a slide set.

Audiences for these resources include LA leaders, chief executives and other senior officers and councillors, as well as Directors of Public Health, public health specialists and health service commissioners.

Health Matters: Making cervical screening more accessible

PHE has published the latest Health Matters, this time focussing on how to make cervical screening more accessible. The resource outlines how LAs, CCGs and GPs can all play a key role in raising awareness of cervical screening and encouraging women to attend screening.

It covers the human papillomavirus vaccination programme, the NHS cervical screening programme and how to address barriers to screening attendance.

Better mental health: JSNA toolkit

PHE has published a toolkit which signals the intent of the National Mental Health Intelligence Network’s intent to support the development of mental health and wellbeing Joint Strategic Needs Assessments (JSNAs).

The Mental Health and Wellbeing JSNA toolkit links mental health data, policy and knowledge to help planners understand needs within the local population and assess local services.

Mental health and behavioural conditions account for nearly one-in-three known fit notes

NHS Digital has published a statistical publication, in collaboration with The Work and Health Unit, jointly sponsored by the Department for Work and Pensions and the Department of Health. It presents data on electronic fit notes issued in GPs across England. The report covers the period from 1st December 2014 to 31st March 2017.

Key facts in the publication include:

  • 1 fit note per 48 patients aged 18-65 years, was issued by GPs on average each month;
  • 5% of fit notes reported were classified as ‘may be fit for work’, with 4 out of 5 of these recommending an adaptation in the workplace, working hours or duties; and
  • 3% of fit notes with a known diagnosis were for mental and behavioural disorders compared to 18% for diseases of the musculoskeletal system and connective tissue.

Media monitoring

Tuesday 29th August 2017

  • The Telegraph has reported on a new study by the University of Manchester whose findings recommend that patients should be given regular urine tests to ensure they are taking medication to identify those patients who are ignoring prescriptions and encourages greater compliance. This was also covered by the Daily Express.
  • The Guardian has reported on a medical study conducted in Boston which has revealed that anti-inflammatory injections could lower the risk of heart attacks and may slow the progression of cancer, in what researchers say is the biggest breakthrough since the discovery of statins. This was also covered by the BBC, and the Daily Express.
  • The Sun has reported on plans by the American FDA to reduce the levels of nicotine in cigarettes in order to make them less appealing to consumers. If successful in reducing addiction levels, such measures may be adopted in the UK.
  • The Daily Express has reported that arthritis suffers who take ibuprofen are at a greater risk of high blood pressure and strokes. The warning was issued yesterday by scientists during a conference in Barcelona on cardiovascular disease. Delegates were told new research has revealed that ibuprofen – one of the most widely prescribed drugs in the world – increased blood pressure more than other non-steroidal anti-inflammatory drugs.

Wednesday 30th August 2017

  • The Daily Mail and Telegraph have both reported on plans from MedExpress to start delivering drugs by drone in the UK following some successful trials.
  • The Guardian and Daily Mail have reported that NHS England has secretly pledged additional funding to CCGs which establish panels of doctors to review GP referrals to hospital – with the intention of reducing the overall number of referrals.

Thursday 31st August 2017

  • The NHS has offered recruiters £100 million over three and half years to boost GP numbers in England, the FT reports. Meanwhile, the Times suggests  that plans for GPs to monitor colleagues’ referrals could pose a safety risk.
  • The Times reports on failings by ambulance services and call handlers leading to deaths and interventions by coroners.
  • The Telegraph reports on signs of heart failure in obese toddlers.
  • The Guardian highlights a Nuffield Trust study, suggesting a hidden overspend of £3billion between NHS Trusts, making it ‘next to impossible’ to reach financial targets.
  • A ComRes poll has found nine in ten MPs believe the care system is not fit for purpose, the Mail reports.

Friday 1st September 2017

  • The Telegraph has reported on how the National Institute of Health and Care Excellence has rejected the anti-cancer drug Fulvestrant due to a lack of evidence that it can extend lives. This is despite trials showing the drug stalls the cancer’s growth by around three months. This was also covered by the Daily Mail.
  • The Guardian also reported on NHS plans to spend £100 million bringing in 3,000 GPs from abroad to help boost numbers in the UK. Recruitment agencies will earn £20,000 for each GP they succeed in placing in a family doctor practice in England as part of the NHS England initiative to boost the number of GPs by 5,000 by 2020.This was also covered by the BBC.

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