Health & Care Review

Health & Care Review

July 11, 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.

New NHS app will make it quicker and easier to access health services

The Department of Health and Social Care (DHSC) has announced that a new NHS app, developed by NHS Digital and NHS England, will be available to everyone in England from December 2018.

The new NHS app will give patients safe and secure access to their GP record, and the ability to make GP appointments; order repeat prescriptions; manage long-term conditions; and access NHS 111 online for urgent medical queries. Patients will also be able to use the app to state their preferences relating to data-sharing; organ donation and end-of-life care.

NHS England National Director of Operations and Information Matthew Swindells said: “In the NHS’s 70th year, the new app will take the NHS to a world-leading position by empowering all our patients using digital technology to take charge of their own healthcare and contact the NHS in a way that suits them.”

Around 1.6 million fewer adult smokers in England in six years

Information relating to the number of adult smokers in England between 2011-2017 has been published by NHS Digital, Public Health England (PHE) and the Office for National Statistics (ONS).

Official figures, from NHS Digital, show that the number of adult smokers has dropped in England from 19.8% of adults (7.7 million) in 2011 to 14.9% (6.1 million) in 2017.

Other key statistics include:

  • adults aged 25 to 34 were most likely to smoke (20%), whilst those aged 65 and over were least likely to smoke (8%);
  • the number of items dispensed as an aid to stop smoking in England was 0.86 million in 2017/18, compared to 2.48 million in 2007/08 and a peak of 2.56 million in 2010/11; and
  • prevalence of e-cigarette users in 2017 for adults remained similar to 2016, at 5%, an increase from 4% in 2014.

£215 million research fund to tackle the next generation of health challenges

DHSC has announced that leading academics and technology experts will be able to apply or research funding to develop health solutions for the future. The research, worth £215 million, aims to give patients greater independence and choice about how they manage their healthcare.

The research will cover many topics, which include:

  • the pressures of an ageing population and increasing demands on the NHS;
  • behavioural science;
  • adult social care;
  • older people and frailty; and
  • cancer awareness, screening and early diagnosis.

Paramedics to be given body cameras to protect them from abuse

DHSC has announced that as part of a new wellbeing pledge for NHS staff, paramedics will be given body cameras to protect them from physical and verbal abuse. NHS Employers will also introduce fast access systems to speed up access to free mental support and physiotherapy for their staff.

In an initial pilot, 465 ambulances and their paramedics will be equipped with body cameras, with potential for a full rollout to all paramedics, and other priority areas.

In the past year, 354 prosecutions have been brought against individuals who have subjected ambulance staff to violence – but estimates suggest this is a fraction of the total incidents.

New law introduced to protect vulnerable people in care

A new bill was introduced to the House of Lords on Tuesday 3rd July to replace the current process for assessing people who do not have mental capacity to make decisions about their care.

The Mental Capacity (Amendment) Bill seeks to replace the current system known as ‘Deprivation of Liberty Safeguards’ which has been criticised for being too complex and bureaucratic.

The reforms seek to:

  • introduce a simpler process that involves families more and gives swifter access to assessments;
  • be less burdensome on people, carers, families and local authorities;
  • allow the NHS, rather than local authorities, to make decisions about their patients, allowing a more efficient and clearly accountable process;
  • consider restrictions of people’s liberties as part of their overall care package; and
  • get rid of repeat assessments and authorisations when someone moves between a care home, hospital and ambulance as part of their treatment.

NHS70 – Seven facts for seven decades

In celebration of the NHS’s 70th birthday, NHS Digital has released an infographic with seven statistics on the NHS across seven decades.

The figures demonstrate how the NHS has evolved since it began on July 5, 1948, and the changing health and lifestyles of the population.

Key statistics include:

  • in 1979, there were 23,062 GPs working in England of which 19,197 were male and 3,865 were female. In 2017 there were 39,843 GPs working in England, of which 21,055 were female;
  • in 2008, there were 35,960,539 antidepressant prescription items dispensed in the community in England. In 2017 this had risen to 67,530,375 items; and
  • in 2016/17, there were 617,000 admissions in NHS hospitals where obesity was a factor. This was an increase of 18% on 2015/16.

 Multi-million pound investment in new ambulances for the NHS

The Government has made a £36.3 million investment in new and updated ambulance vehicles to help staff provide emergency care to patients this winter.

Nationally, the investment will buy 256 new state-of-the-art vehicles, more than half of which will be on the road for this winter. Funding will also go towards hubs at ambulance trust headquarters, which will allow better restocking and maintenance of vehicles.

Demanding better: The social determinants of health care demand

The Nuffield Trust has published a report on how the health and care system should respond to the increasing effects of social circumstances on people’s health care needs.

The report cites examples of how social determinants of health have a significant impact on health and demand for health care, such as higher numbers and rates of admissions to hospital.

Proposed interventions include:

  • the coding of GP records needs to capture social risk factors in ways that make them easy to find in a consultation or needs assessment;
  • more multidisciplinary models of general practice and the inclusion of mental health in front-line primary care; and
  • in appropriate settings the inclusion of welfare, housing and other advice and support also makes a difference.

Diabetes not taken seriously by UK public

New research by Diabetes UK suggests that diabetes is not taken seriously by the UK public. A survey spoke to 1,000 people with and without a link to diabetes and demonstrates the extent of this lack of awareness.

Key facts include:

  • 2% of people spontaneously said a stroke was a complication of diabetes, 4% said kidney damage and 6% said heart disease;
  • only 1 in four people (25%) of people said, unprompted, that amputation and sight loss were linked to diabetes; and
  • no-one spontaneously knew that diabetes could cause problems in pregnancy, only 2% knew diabetes could lead to a shorter life span, and only 4% knew it could lead to early death.

Beyond barriers: how older people move between health and care in England

The Care Quality Commission (CQC) has published a report which reviewed how the local area works together to support and care for peopled aged 65 years and over. The report looks at 20 LA areas and covers three specific issues:

  • Maintaining people’s health and wellbeing at home
  • Care and support when people experience a crisis
  • Supporting people when they leave hospital

The report found that organisations did intend to work together but often focussed on their own goals; the way services were funded did not support them to work together. Additionally, the regulatory framework only focusses on individual organisations.

The CQC recommends reform of planning and commissioning of services; a new approach to system performance management; joint workforce planning; and better oversight of local system performance.

Evidence Based Interventions: Consultation

NHS England has launched a consultation on new proposals jointly developed by NHS England, NHS Clinical Commissioners, the Academy of Royal Medical Colleges, the National Institute for health and Care Excellence and NHS Improvement’s GIRFT programme in collaboration with the Royal Colleges and patient groups such as Healthwatch.

The proposals are designed to reduce the delivery of interventions regarded as ineffective, such as breast reductions, snoring surgery, haemorrhoid surgery and tonsillectomies.

The consultation will last 12 weeks, ending on 28th September 2018.

NHS England inviting views to help shape modern primary care says NHS England as part of NHS Long Term Plan

NHS England is inviting GPs, patients and healthcare professionals to express their views on general practice reform to provide a stronger and more sustainable service as part of the new NHS Long Term Plan.

In particular, with a wide range of partners, NHS England has reviewed the Quality and Outcomes Framework (QOF) which provides payments for achieving outcomes that reflect high quality care in general practice. NHS England is also seeking views on how general practice payment models can best support innovation.

The outcome of this engagement will inform GP contract negotiations for 2019 – 2020 between NHS England and the General Practitioners Committee of the British Medical Association.

Thousands of patients to benefit from innovative new treatments on the NHS

NHS England will be introducing new treatments available to patients as a result of the latest specialised commissioning prioritisation process.

Treatments are grouped into five levels of priority, with those that cost less and offer more clinical benefit for patients relative to the other treatments being considered classified as level one, and treatments with the lowest relative clinical benefit and highest cost placed in the lowest category, level five.

Media monitoring

On Monday 2nd July 2018, the following story was published:

  • iNews and The Mail report that a study has found air pollution is responsible for nearly 15,000 cases of diabetes a year.

On Tuesday 3rd July 2018, the following stories were published:

  • The BBC reports that data for 150,000 patients has been involved in a data breach. SystmOne software used by GPs was used to record patient’s preferences regarding data-sharing, but it appears that messages from those who requested their data not be used for research and auditing purposes were not sent through to NHS England’s IT provider. Also covered by The Telegraph, The Times, The Mirror, The Mail and The Sun.
  • The Telegraph reports that there has been a five-fold increases in measles cases in England in the past year. Public Health England says outbreaks have mostly been affecting your adult who missed out on the MMR vaccine when they were younger. Also covered by The Times and The Guardian.
  • The Sun reports that tests have shown that taking aspirin daily could protect people from dementia. Also covered by The Mail, The Express and ITV News.

On Wednesday 4th July 2018, the following stories were published:

  • The Guardian reports that Home Secretary Sajid Javid is considering relaxing the rules on prescribing cannabis for medical use. An in-depth review led by Chief Medical Officer Dame Sally Davies will look at possible plans, including moving cannabis from a Schedule 1 to a Schedule 2 Controlled Drug. Also covered by the BBC, The Times, The Independent, The Telegraph The Mirror and The Sun.
  • Poor rural broadband could prevent elderly people from accessing crucial at-home help, reports The Telegraph. The Local Government Association warns that “rural communities face increasing isolation from health services”. Also covered by The Express.
  • The BBC reports that Public Health England is advising that people should be doing strengthening exercises at least twice a week to help us ‘age better’. Also covered by The Guardian and The Mail.
  • The Mail reports on a study that found taking folic acid during pregnancy can protect against mental health issues in the unborn child.

On Thursday 5th July 2018, the following stories were published:

  • The Telegraph reports that tech company Babylon, who are behind the app GP at Hand, plan to open its own private GP surgeries.
  • The Health Service should text patients to remind them of appointments after almost half a million people failed to show up for a consultation last year, an executive has said. It is thought that 477,000 patients missed outpatient appointments last year. Featured in The Times.

On Friday 6th July 2018, the following story was published:

  • GP vacancies rise to record levels despite recruitment pledge. The Independent reports on the results of a survey by Pulse magazine, which states that GP vacancies have risen from 9.1% to 15.3% since the Government pledged to recruit 5,000 more doctors. The Telegraph features a similar story, including a quote from Helen Stokes-Lampard, Chair of the RCGP, who claims that almost every surgery in England is at least one GP short.

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