Health & Care Review

Health & Care Review

July 3, 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.

The NHS at 70

Researchers from the King’s Fund, the Health Foundation, the Institute for Fiscal Studies and the Nuffield Trust have collaborated to highlight some key issues facing the NHS as requested by the BBC.

The report covers five key topics: strengths and weaknesses of the health service; the state of social care; NHS funding; the public’s expectations of the NHS; and the potential of technology to change things in the future.

The reports are available and have been entitled as:

  1. How good is the NHS?
    This report looks into three aspects of a good health care system – comparing access, efficiency and outcomes in the UK to 18 similar countries. A key strength is that is provides unusually good financial protection to the public from consequences of ill health, however, the UK performs worse than the average in the treatment of 8 out of 12 most common causes of death.
  2. What can we do about social care?
    This report explains the current pressures on social care and its impact in England, and sets out the barriers and potential solutions to funding reform.
  3. Does the NHS need more money?
    This report examines whether the NHS still required more funding, taking into account current health spend and inflation, and how we could find more money.
  4. Are we expecting too much from the NHS?
    This report explores the public’s expectations of the NHS, the balance between meeting them and living within a constrained budget. It also considers who is responsible for keeping us healthy. Public satisfaction with services remains high but people are becoming increasingly concerned about the NHS, particularly in relation to lengthening waiting times and the level of funding provided by the government.
  5. What dilemmas will new technology pose for the NHS?
    This report provides examples of developments that failed; current trends and what they might mean for health care if they continue. Implementation of technology takes time and requires shifts in workforce and investment.

The public and the NHS: what’s the deal?

The King’s Fund, in partnership with Ipsos MORI has been exploring how the public views its relationship with the NHS through three workshops. A report has been published to highlight the key issues.

The workshops found that while the public was committed to the founding principles of the NHS, there were key areas where the NHS could improve which included waste.

Broadly, participants saw the NHS/Government as having a responsibility to:

  • provide easy to access services;
  • use resources efficiently and reduce waste;
  • employ enough staff and treat them fairly;
  • provide support and advice to people to help them stay healthy; and
  • treat all patients equally.

In return, the participants identified the public’s responsibilities to:

  • use NHS services responsibly;
  • stay healthy;
  • pay for the NHS through taxes;
  • support the community; and
  • value the NHS.

England’s poorest areas are fast food hotspots

Public Health England (PHE) has published new figures which reveal that England’s poorest areas have the highest density of fast food outlets.

An analysis produced by the Food Standards Agency and the Food Hygiene Rating Scheme shows that the most deprived areas have five times more outlets than in the most affluent. Additionally, fast food outlets account for more than a quarter of all eateries in England.

Many local authorities across England have taken action to address their food environment and PHE is encouraging them to learn from each other. At least 40 areas have developed policies to restrict the growth of new takeaways and fast food outlets, and PHE has helped develop stronger planning guidance to support other areas in doing this.

Financial incentives effective at reducing antibiotic prescribing

The impact of the Quality Premium, a national incentive scheme, introduced to reward Clinical Commissioning Groups (CCGs) for improving their services on the rate of antibiotic prescribing has been assessed by PHE and Imperial College London. The results show that the number of patients prescribed antibiotics by their GP for common respiratory infections fell by 3%. An evaluation of the findings has been published in the Journal of antimicrobial Chemotherapy.

Local health and care partnerships covering 23.5 million could save lives

NHS England recently announced new areas chosen to become Local Health and Care Record Exemplars. These are new partnerships that receive funding to put in place an electronic shared local health and care record which makes relevant information held about people available in an instant to everyone involved in their care and support.

Recent areas are Yorkshire and the Humber as well as Thames Valley and Surrey. They are in addition to the previously announced sites: Greater Manchester, Wessex and One London. This means over 40% of the population of England will be covered by a shared local health and care record.

NHS England and UK Space Agency launch multi-million pound drive to improve patient care

NHS England has announced a joint initiative with the UK Space Agency to find hi-tech solutions to the major health and care challenges facing the NHS. The Agency will be allocating up to £4 million for the initiative.

NHS England’s chief Executive has outlined the key challenges:

  • managing long term conditions, including joining up health and care services;
  • earlier diagnosis of cancer;
  • transforming GP services and other primary care;
  • meeting mental health needs.

Innovators will bid for money to turn technology originally designed for space, from exploration to satellite communications, into medical applications that improve NHS treatment and care.

Up to four applications will receive UK Space Agency funding to develop their ideas along with support and advice from the body, NHS England and the European Space Agency.

‘Red bags’ to be rolled out across England’s care homes getting patients home from hospital quicker

NHS England will be rolling out a nationwide ‘red bags’ scheme to speed up the hospital discharge process of care home residents.

The bags, which contain key paperwork, medication and personal items like glasses, slippers and dentures, are handed to ambulance crews by carers and travel with patients to hospital where they are then handed to the doctor.

This scheme is based on a pilot which started three years ago in Sutton, South West London, which showed:

  • hospital stays were reduced by three to four days, saving £167,000 a year;
  • patients stopped losing personal items such as dentures, glasses and hearing aids; and
  • communication was improved between care home and hospital staff saving time, resources and duplication.

Government must double number of medical students

The Royal College of Physicians (RCP) has published a report which calls on the Government to double the number of medical school places from 7,500 to 15,000 to meet growing demand in the future. The College suggests that an additional 2,840 medical students per year is needed for the next five years to create 2,270 additional consultant physicians in 2030.

Providing smoking cessation for patients in hospitals will save lives and money

The RCP has published a report, Hiding in plain sight: Treating tobacco dependency in the NHS which calls for a radical change in the way the NHS treats smoking by providing opt-out cessation services as a routine component of all hospital care.

It argues that smoking cessation is not just about prevention, but can also be viewed as active disease management. Currently NHS smoking cessation services rely on the patient to seek help themselves which may have been more successful in the past. Most health professionals receive little or no training in treating smokers, and smoking treatment may at times be squeezed out, even in the management of diseases caused by smoking.

key recommendations made in the report include:

  • smoking cessation should be incorporated, as a priority, as a systematic and opt-out component of all NHS services as a complement to local authority services, and delivered in smoke-free settings;
  • we should allow e-cigarettes to be used on NHS sites to support smokers to remain smoke-free and help to sustain smoke-free policies;
  • legislation requiring hospitals to implement completely smoke-free grounds should be introduced, as the current guidance isn’t being implemented; and
  • training in smoking cessation should be introduced into all undergraduate and postgraduate healthcare professional training curricula and as mandatory training for the entire NHS healthcare professional workforce.

Health matters: reproductive health and pregnancy planning

PHE has published the latest edition of Health Matters, with this issue looking at reproductive health and pregnancy planning. This professional resource focusses on an integrated approach to better enable populations to be healthier at an earlier stage in preparation for a pregnancy, if they choose to have one or avoid unintended pregnancies if they do not.

The resource is accompanied by infographics, a blog, a video and case studies.

MPs Call for Social Care Premium to fund personal care for all

The House of Commons Health and Social Care and Housing, Communities and Local Government Committees have published a joint report which calls for a sustainable funding solution for adult social care.

The report calls for the introduction of a ‘Social Care Premium’, either as an additional element of National Insurance or with the premium paid into dedicated not-for-profit social insurance fund that people would be confident could only be used for social care.

The report is based on six principles for funding social care that the Committees recommend should underpin the development of social care policy.

  • providing high quality care;
  • considering working age adults as well as older people;
  • ensuring fairness on the ‘who and how’ we pay for social care, including between the generations;
  • aspiring over time towards universal access to personal care free at the point of delivery;
  • risk pooling – protecting people from catastrophic costs, and protecting a greater portion of their savings and assets; and
  • ‘earmarking’ of contributions to maintain public support.

Media monitoring

On Saturday 23rd, Sunday 24th and Monday 25th June 2018, the following stories were published:

  • The government is planning new rules to tackle childhood obesity by targeting supermarkets, junk food adverts and restaurant menus. The tighter restrictions have been broadly welcomed and include banning the sale of sweets at checkouts, shop entrances and in buy-one-get-one-free deals. The BBC, The Sun, ITV, The Guardian, The Independent and The Times.
  • Two in five health supplements may not contain what they claim on the label, research suggests. Results from the British Herbal Medicine Association study suggest 30-40% of milk thistle and echinacea supplements sold in shops did not contain the active ingredient as described on the label. Featured in The Telegraph.

On Tuesday 26th June 2018, the following stories were published:

  • A joint letter to the editor of The Guardian, from the Patients Association, Diabetes UK, NPA and others, calls for an end to inequalities in health characterised by variations in life expectancy. The organisations suggest a test of the forthcoming long-term NHS plan will be whether the poorest patients and communities benefit from the new investment promised. Published in The Guardian.
  • The BMA have called for girls and boys to be given the HPV vaccine while at primary school. Currently the vaccine is only offered to girls from the age of 12, despite its effectiveness among both sexes. Featured in The Telegraph and The Mirror.

On Wednesday 27th June 2018, the following stories were published:

  • The BMA has called for a cap on the number of patients seen by GPs each day. Medics said they were too often expected to have up to 70 consultations a day and that this is not safe for them or for patients. Doctors are hailing the system in Sweden where GPs see just 13 patients daily. Featured in The Telegraph and The Mail.
  • Independent analysis produced for the BBC found that seven in ten adults do not meet the recommended guidelines in relation to diet, physical activity, drinking and smoking. Experts suggest the Government should tax and regulate more to encourage people to be healthier.

On Friday 29th June 2018, the following story was published:

  • Regularly seeing the same doctor can halve death rates as the GP will know the patient better and the patient is thought to be more honest and trusting of the GP’s advice. The RCGP has said that workload pressures mean that practices cannot always offer this. This story was covered by The Times, The Telegraph, The Mirror, The Guardian, the BBC, The Sun and The Mail.

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