Health & Care Review

Health & Care Review

January 12, 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.

Tackling high blood pressure: an update

Public Health England (PHE) has published an updated action plan, based on evidence and practical experience, to tackle the issue of high blood pressure. The updated plan was developed by the Blood Pressure System Leadership Board, which is hosted by PHE, following an initial plan published in 2014.

The updated commitments that are outlined in the action plan have been categorised into four categories:

  • prevention;
  • detection;
  • management; and
  • cross-cutting.

The report covers the importance of taking action; how to tackle high blood pressure; latest achievements; future commitments; a call to action; and how different groups can contribute.

UK flu levels continue to increase according to PHE statistics

PHE has published the latest statistics relating to seasonal flu levels as part of their weekly national flu reporting series.

Key facts include:

  • there has been a 78% increase in the GP consultation rate with flu-like illness;
  • there has been a 50% increase in the flu hospitalisation rate; and
  • there has been a 65% increase in the flu intensive care admission rate.

Approximately 71% of adults over 65, 46% of adults with a long-term health condition, 45% of pregnant women, 40% of 3-year-olds and 42% of 2-year-olds have received the vaccine so far.

Winter pressure is watershed moment for the future of the NHS

NHS Providers has written to the Secretary of State for Health and Social Care to voice concerns about the increasing pressures facing frontline health and care services.

NHS Providers represents 98% of hospital, mental health, community and ambulance service trusts in England, and it states that it is no longer possible to meet the standards set out in the NHS Constitution within the current funding.

An increase in flu cases, more respiratory illness and cold weather has exacerbated pressures meaning the health and social care system can no longer fully recover performance targets, consistently maintain high-quality patient care, invest in capital requirements and join up services to deliver 21st century care.

NHS England has published a combined performance summary for December 2017 and the figures show:

  • emergency admissions in December reached 520,163 – the highest monthly figure on record;
  • the general and acute average bed occupancy was 95%; and
  • four-hour performance in major A&E departments was 77.3% – the lowest on record.

CQC responds to increased pressure on health and social care by pausing some routine inspections

The Care Quality Commission (CQC) has, as a result of increased pressure on health and social care, decided to pause some routine inspections of NHS acute services.

CQC will continue to carry out inspections scheduled based on concerns about quality of safety. There will be a temporary pause in re-inspections of GP practices and urgent services (including NHS 111, GP Out of Hours and urgent care centres) rated good or outstanding where there is no information to indicate concerns about quality of safety.

Similarly, unannounced adult social care inspections based in response to risk and to follow up concerns will be unaffected.  Re-inspections of services rated ‘requires improvement; or ‘inadequate’ will continue as normal.

A normal inspection schedule is expected to resume in February but this will be subject to review.

Sugary drinks face NHS ban if action is not taken

Two-thirds of NHS trusts have now signed a voluntary scheme to reduce the sales of sugar drinks to 10% or less of total sold beverages. NHS England has warned that hospital trusts have until the end of March 2018 to take action or there will be a ban introduced in 2018 instead.

NHS England’s voluntary sugary drinks reduction scheme covers sugary soft drinks, milkshakes and hot drinks with added sugar syrups.

NCMP Local Authority Profile: academic year 2016 to 2017 update

PHE has published the latest update on the National Child Measurement Programme (NCMP) Local Authority Profile tool with data from the 2016/17 academic year added.

The main findings include:

  • the average percentage of severely obese Reception age children in England was 2.4% and for Year 6 children it was 4.1%;
  • NCMP data shows that severe obesity prevalence in children has strong associations with ethnic group, deprivation and sex; and
  • trend data for boys and girls reveals that the percentage of overweight and/or obese boys is consistently greater than the percentage of girls.

Working together to reduce duplication in general practice

CQC has worked with NHS England and been supported by NHS Clinical Commissioners to develop a joint working framework to help reduce duplication in the regulation of general practice.

Tuberculosis in England: annual report

PHE has published the latest report on tuberculosis (TB) in England, presenting data to the end of 2016.

Key facts in the report include:

  • in 2016, there were 5,664 TB cases notified in England, down from 5,727 in 2015;
  • following a sustained annual decline of at least 10% in the number of TB cases since 2012, the decline in 2016 slowed to 1%; and
  • as in previous years, the main burden of disease was concentrated in large urban areas in London PHE centre accounting for the highest proportion of cases in England.

House of Commons briefing on Accountable Care Organisations

The House of Commons Library has published a briefing which explores Accountable Care Organisations (ACOs) as a model of healthcare organisations and the future roles of GPs and Clinical Commissioning Groups in an ACO system.

The proposed introduction of ACOs in the NHS in England has generated some commentary as to a potential increase in private sector involvement, in part due to the model’s origin in the American healthcare system.

The briefing suggests that the ACO system has been described as a threat to GP independence.

Thinking on its own: AI in the NHS

Reform has published a report to illustrate the areas where artificial intelligence (AI) could help drive NHS efficiencies and improve patient outcomes. The report suggests that AI could have a role in the following areas:

  • AI could help address the health and wellbeing gap by predicting which individuals or groups of individuals are at risk of illness and allow the NHS to target treatment more effectively towards them;
  • The reduction of the care and quality gap could be supported by AI tools as they can give all healthcare professionals and patients access to cutting edge diagnostics and treatment tailored to individual need; and
  • AI could help address the efficiency and funding gap by automating tasks, triaging patients to the most appropriate services and allowing them to self-care.

The report also makes a series of recommendations, the first of which is that NHS Digital and the 44 Sustainability and Transformation Partnerships should consider producing reviews outlining how AI could be appropriately and gradually integrated to deliver service transformation and better outcomes for patients at a local level.

Fatigue and sleep deprivation

The British Medical Association has published a briefing to raise awareness about doctor fatigue along with the acute and long-term impacts this can have. It also presents a framework for the Government, organisations and doctors to use and manage the risk.

The briefing highlights that doctors and other clinical staff are at an increased risk of fatigue due to specific factors which include long working hours and intense workload, increasing numbers of patient consultations ‘decision fatigue’, unpredictable interruptions and shift work.

Media monitoring:

On Tuesday 9th January 2018, the following stories were published:

  • The Sun reported that antibiotics will not stop the spread of the Australian ‘flu virus whilst the Daily Mail suggests that Sir Bruce Keogh is considering making it mandatory for all NHS staff to have the flu vaccination after the spread of this strain of the virus.
  • Several papers have covered a story about ibuprofen being linked to male infertility, including the Guardian, Daily Mail and Sun.

On Wednesday 10th January 2018 the following stories were published:

  • The Times has reported on a new study which has shown that two thirds of people who try a cigarette go on to become daily smokers.
  • The Financial Times reports that Jeremy Hunt will take charge of a government inquiry into the reform of social care, despite funding remaining with local government. This was also covered by the Guardian.
  • The Daily Telegraph has reported that nearly a million patients are overpaying for prescriptions because the NHS is failing to promote annual prescription prepayment certificates.
  • There is an article in the Guardian, written by GP Zara Aziz and which offers a front line view of the winter crisis in an NHS hospital, detailing the pressures on ambulances, A&E and hospital wards.
  • The Daily Mirror also reports that an extremely contagious strain of ‘Japanese’ flu which particularly affects children has hit the UK. The virus has already hit Ireland and now doctors in the UK are already encouraging parents to have their kids vaccinated against Yamagata flu

On Friday 12th January 2018 the following stories were published:

  • The first is that ‘flu levels are reportedly ‘soaring’, with one in five hospital cases involving the ‘Aussie’ strain of the virus. This has been covered by the Sun, Times, Telegraph, BBC and ITV.
  • The heads of more than 60 A&E departments have warned the Prime Minister that patients are dying prematurely in their corridors, as the A&E crisis escalates. This has been reported by the Guardian, Mirror, Sun, BBC, FT, ITV and on last night’s Channel 4 News.


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