Health & Care Review

Health & Care Review

October 16, 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.

Prime Minister launches world-leading project on impact of ethnicity on everyday life

The Prime Minister has launched a new website, ‘Ethnicity Facts and Figures’, to publish the findings on a new audit of how people from different backgrounds are treated by public services.

The new website contains thousands of statistics covering more than 130 topics in areas including health, education, employment and the criminal justice system.

The health section of the website includes outcomes for different ethnic groups from data collected by Government departments, local authorities (LAs), hospitals, health trusts and related organisations. The data covers access to treatment, patient experiences, patient outcomes, physical and mental health and preventing illness.

Jeremy Hunt announces salary supplement for trainee GPs

The Health Secretary has announced new funding to be made available to support general practice.

From 2018, GP practices in areas where recruitment is difficult will receive funding from the new Government-backed Targeted Enhanced Recruitment Scheme to offer a one-off payment of £20,000 to attract trainees to work.

New £15 million programme to help train one million in mental health first aid

Public Health England (PHE) has designed a new campaign which will see up to one million people trained in basic mental health ‘first aid’ skills with a £15 million investment from the Government.

The campaign will launch next year, for three years, and PHE will work closely with Mental Health First Aid England and other related organisations to ensure the campaign is fit for purpose. There will be an online learning module designed to improve the public’s knowledge, skills and confidence in mental health.

Health app assessment: criteria

PHE has published a guidance document aimed at health app developers and commissioners on what they should consider when developing and submitting a health app for assessment.

The guidance covers:

  • evidence of effectiveness;
  • regulatory approval;
  • clinical safety;
  • privacy and confidentiality;
  • security;
  • usability and accessibility;
  • interoperability; and
  • technical stability.

CQC’s State of Care report published

The Care Quality Commission (CQC) has published its annual State of Care report which looks at trends of care across England during 2016/17. The report has been compiled using inspections and ratings data, along with other information including that from service users as well as their families and carers.

The data in CQC’s report covers:

  • 21,256 adult social care services;
  • 152 NHS acute hospital trusts;
  • 197 independent acute hospitals;
  • 18 NHS community health trusts;
  • 54 NHS mental health trusts;
  • 226 independent mental health locations;
  • 10 NHS ambulance trusts; and
  • 7,028 primary medical care services.

Key facts highlighted in the report include:

  • 2 million older people have unmet care needs – up from 1 million last year;
  • 5 million people spent longer than four hours in A&E in 2016/17 – up from 1.8 million last year;
  • from January to March 2017, the NHS had the highest ever acute hospital bed occupancy at 91.4%; and
  • rising demand for GP services is not being matched by a growth in the workforce to meet needs, which means that people may find it harder to access an appointment with a GP.

Prevention in action: How are prevention and integration being implemented?

The British Red Cross has published a new report on how prevention and integration are being understood and prioritised locally in England.

The report focusses on how councils have acted on the Care Act’s vision for prevention and local services.

Key findings in the report include:

  • 37% of joint health and wellbeing strategies still do not incorporate a full understanding of prevention;
  • all too often, LAs and Health and Wellbeing Boards fail to recognise the importance of interventions aimed at minimising deterioration and the loss of independence for people with established needs, or preventing the reoccurrence of a health and social care crisis (i.e. ‘tertiary’ types of prevention);
  • LAs and Sustainability and Transformation Partnerships (STP) also demonstrate an inconsistent level of understanding of ‘integration’ as well as ambition; and
  • local decision makers across the board emphasise both the need to invest in prevention and integration as well as the practical difficulties of doing this, especially in the current economic climate.

Professional regulation in health and social care

The House of Commons Library has published a briefing on professional regulation in health and social care which describes the main functions of professional regulators and highlights common debates surrounding health regulation.

Sexual and Reproductive Health Services, England – 2016/17

NHS Digital has published statistical data relating to activity taking place in Sexual and Reproductive Health (SRH) services. These include family planning services, community contraception clinics, integrated genitourinary medicine and SRH services and young people’s services.

Key facts include:

  • 7% of the resident female population between the ages of 13 and 54 had at least one contact with an SRH service. For males in the same age group, 1% of the resident population had at least one contact;
  • females aged 18 to 19 were most likely to use an SRH service, with 18% having at least one contact; and
  • the number of emergency contraception items provided to females by both SRH services and at other locations in the community has fallen by 42% over the last ten years, from 457,000 in 2006/07 to 264,000 in 2016/17.

Getting into shape: delivering a workforce for integrated care

Reform has published a report on how a new NHS workforce policy could be implemented to support integrated care and reform.

Some of the recommendations include:

  • undergraduate training should be uncapped across the health and social care system;
  • doctors who choose not to work for the NHS should reimburse the cost of their training;
  • STP training budgets should be included within their funding envelope and they must seek to deliver training that cuts across all sectors and for all staff; and
  • STPs should develop and trial the full range of alternative and flexible routes into health and social care.

House of Commons briefing on STPs

The House of Commons Library has published a briefing on STPs and explores how STPs have been developed, their funding and accountability arrangements and progress they have made so far.

People with learning disabilities: health checks audit tool

PHE has published an audit tool designed to check the quality of health checks for people with learning disabilities.

The tool can be used to:

  • identify good practice and encourage services to improve their practice further;
  • establish whether health checks and primary care services are provided consistently across a geographical area;
  • monitor progress; and
  • embed key ‘reasonable adjustments; within primary care.

Adult social care funding: State of the nation – October 2017

The Local Government Association has published a document on adult social care and what the Government needs to do to encourage high-quality, person-centred and safe care.

Key facts in the document include:

  • English councils will have managed reductions to their core funding from national Government totalling £16 billion between 2010 and 2020;
  • the consequences of underfunding include an ever more fragile provider market, growing unmet need, further strain on informal carers, less investment in prevention, continued pressure on an already overstretched care workforce, and a decreased ability of social care to help mitigate demand pressures on the NHS; and
  • in dealing with the pressures facing social care and health in the short and long-term, the Government must develop a balanced approach that does not give one part of the system primacy over the other.

Half of adults aged 55 and over have experienced mental health problems, says Age UK

Age UK has collaborated with NHS England to encourage older people to see their GP if they experience symptoms suggestive of mental health disorders.

New YouGov research for Age UK has revealed that death of loved ones (36%) ill health of themselves (24%) and financial worries (27%) are the most common triggers for mental health problems.

Age UK and NHS England are also calling on GPs to spot the warning signs of worsening mental health. A new guide by NHS England, ‘Mental health in older people’ has been published to help GPs spot signs of anxiety and depression, and identify a range of mental health problems including those which specifically affect older people.

New NHSCC report shows mental health ‘of primary importance’ to CCGs

NHS Clinical Commissioners has launched a new report, ‘Of primary importance: Commissioning mental health services in primary care’ featuring case studies of Clinical Commissioning Groups (CCGs) and their partners embedding mental health in primary care. The report aims to share good practice and provide ideas and support to others who wish to adopt similar approaches

Case studies in the report include:

  • Community Living Well in West London which helps those with long-term mental health conditions and covers a full range of psychological therapies from guided self-help, through to sessions of short-term psychodynamic or Cognitive Behavioural Therapy, carers therapy and a wellbeing service;
  • work in Sheffield where Improving Access Psychological Therapies workers are attached to each of the CCG’s individual 85 practices, and are incorporated as part of the practice multidisciplinary team; and
  • the Well Centre, a primary care health centre in Lambeth for young people aged 13 to 20 offering support with all areas of health including mental wellbeing.

PHE Cancer Board plan

PHE has published its approach to coordinating its cancer network for the next five years (2017 to 2021).

It is aligned with the Five Year Forward View and the Independent Cancer Taskforce Report and highlights how PHE will meeting the Taskforce’s recommendations and its role in fighting against cancer.

Condom distribution schemes in England

PHE has conducted a study on condom distribution schemes in England and published the findings in a report. It provides an assessment of the number and types of condom distribution schemes (CDSs) in England and can be used to develop a standardised framework for evaluating C-card schemes.

Key findings include:

  • CDSs were available in nearly all areas of the country;
  • C-card schemes (a type of multi-component CDS) were successful in engaging the key population;
  • pharmacies were the most commonly reported C-Card outlets; GPs were the most commonly reported other CDS outlets;
  • almost equal proportion of young men and young women used C-Card schemes;
  • high number of repeat users of C-Card schemes, including users registered from previous years, were indicative of their success and popularity; and
  • of the reporting LAs, almost £1.5 million was spent on C-Card schemes (£1.4 million) and other CDSs (£0.1 million).

Making the case for quality improvement: lessons for NHS boards and leaders

The King’s Fund has published a report in collaboration with The Health Foundation which makes the case for quality improvement to be at the centre of local plans for redesigning NHS services. It draws on existing literature and examples from the NHS of where quality has been improved.

Key facts highlighted in the report include:

  • now, more than ever, local and national NHS leaders need to focus on improving quality and delivering better-value care. All NHS organisations should be focused on continually improving quality of care for people using their services. This includes improving the safety, effectiveness and experience of care;
  • the use of methods and tools to continuously improve quality of care and outcomes for patients – should be at the heart of local plans for redesigning NHS services;
  • improving quality and reducing costs are sometimes seen as conflicting aims when they are in fact often two sides of the same coin; and
  • the potential benefit is even greater if quality improvement techniques are applied consistently and systematically across organisations and systems. However, this is not currently the case. To deliver the changes that are needed to sustain and improve care, the NHS needs to move from pockets of innovation and isolated examples of good practice to system-wide improvement.

Media monitoring

Saturday 30th September, Sunday 1st and Monday 2nd October 2017

  • This morning, Labour called for an inquiry after the collapse of a private ambulance firm that has contracts with the NHS and other private health organisations, according to the Guardian.

Tuesday 3rd October 2017

  • The Daily Telegraph  reported that a new form of radiotherapy treatment, which shapes radiation beams to tumours, could help patients suffering from prostate cancer, whose condition was previously thought to be incurable. This was also covered by The Times, and the Daily Mail.
  • The Sun reported on a Swedish study which has shown that pensioners prescribed aspirin, should continue to take one aspirin a day to help limit the risk of a heart attack or stroke. This was also covered by the Daily Express.
  • The Times reported that researchers from the University of Nottingham are trying to improve the disposition of patients aged over-65 who visit their GPs to receive their annual flu jab, after discovering that ‘a sunny disposition improves their response to the vaccination.’

Wednesday 4th October 2017

  • The Telegraph reported that nine in ten areas will have a shortage of care home beds within a decade, a watchdog has found. Research by Which? indicates there will be 42,000 fewer care home beds than are needed, and that 87% of areas will be short.

Thursday 5th October 2017

  • The Daily Mail has reported that the British Medical Association has threatened Jeremy Hunt that GP practices will close their lists ‘en masse’ unless additional NHS funding is made available.

Friday 6th October 2017

  • The Daily Telegraph reported that the number of vasectomies carried out by NHS hospitals and clinics has dropped by nearly two-thirds in a decade. Experts said the trend could reflect social shifts, with greater awareness that relationships might not last, and a reluctance to take steps seen as irreversible. This was also covered by the Daily Mail and the Times.
  • The Guardian has reported on comments by the President of the Royal College of Obstetricians and Gynaecologists that Nurses and midwives should be allowed to give women the pills that end an unwanted pregnancy as part of a relaxation of Britain’s abortion laws.
  • The Guardian has also reported that transplant doctors and health charities have praised Theresa May’s decision to change how organ donation works in England and move to a system of presumed consent – meaning everyone is presumed to agree to the removal and reuse of body parts after their death unless they opt out.

Saturday 7th, Sunday 8th and Monday 9th October 2017

  • The Observer had a long feature on antimicrobial resistance and that bacteria are becoming resistant even to the ‘antibiotic of last resort’.
  • The Sunday Telegraph reported that a study has shown that embedding GPs in A&E departments to free up emergency staff slashes waiting times and hospital admissions for children, but increases antibiotic prescriptions.
  • The Telegraph and the Daily Mail reported on comments from the Royal College of General Practitioners (RCGP) that doctors should encourage patients to take their own measurements in order to take responsibility for their own health and help tackle the obesity crisis.
  • The NHS Confederation’s Niall Dickson has said, in the Times, that it is too late to save the NHS from a winter crisis, even if there is a cash injection from Government.
  • Libby Purves in the Times had a column arguing that women should not take the free Pill for granted, citing Trump’s moves to defund Planned Parenthood.

Tuesday 10th October 2017

Wednesday 11th October 2017

  • The Guardian reported that the RCGP is urging ministers to add GPs to the UK’s list of occupations with shortages, to make it easier for overseas doctors to help plug the widening gap in the workforce. The RCGP has written to the Home Secretary, asking her to declare family doctors a key group deserving priority in their efforts to work in the UK.
  • The Guardian also reported that a former chief executive of the NHS is among a thousand signatories to a letter to Jeremy Hunt warning of the risks posed by imposing identification checks and upfront charges for NHS care. School nurses, abortion services, community-based midwifery and mental health services, and services for homeless people and asylum seekers will be included in the new regime. Doctors say the rules will deter sick people from getting life-saving treatment and those with infectious diseases could go undetected.
  • The Daily Mail  reported on a study by Imperial College London and the World Health Organization which has found that four in ten youngsters aged five to 19 were medically obese or overweight.  This up from 2.66 million in 1975 to 4.53 million last year. Similarly, the Daily Mail also reports that junk food companies spend 27 times more on advertising than the Government does on promoting healthy eating The 18 top-spending crisp, confectionery and sugary drinks brands spent more than £143 million last year on advertising their products, according to the Obesity Health Alliance, dwarfing the £5.2 million spent on the Government’s flagship Change4Life healthy eating campaign.

Thursday 12th October 2017

  • ITV and the Telegraph have reported that the Society for Acute Medicine has said that the NHS would be ‘overwhelmed’ and routine operations ‘suspended’ if there is an outbreak of ‘flu this winter.
  • The Guardian and the Daily Mail have reported that RCGP’s Professor Helen Stokes-Lampard has said that many older people are visiting their GP because they are lonely and want human contact.

Friday 13th October 2017

  • The BBC reported on proposals for drug consumption rooms for illegal substances.
  • Dementia maintains a record as the leading cause of death in England and Wales. Finally, across several of the papers and BBC TV , Dame Sally Davies warned of an antibiotic apocalypse, as 10 million people a year could die from drug-resistant infections by 2050.

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