Health & Care Review

Health & Care Review

July 24, 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.

Mental health: how do you know your council is doing all it can to improve mental health

The Local Government Association (LGA) has published a guide to the role of local government in mental health and wellbeing. The main ways in which this happens are through:

  • system-wide leadership through health and wellbeing boards (HWBs);
  • public health responsibilities to promote mental wellbeing and prevent poor mental health throughout the life course;
  • statutory duties and powers related to mental health; and
  • the overview and scrutiny of mental health provision.

The guide sets out questions for local leaders to consider when planning services and key points for good practice.

The gender pay gap in the English NHS: how does it vary by ethnicity?

The Nuffield Trust has published a briefing which looks at pay gap inequalities and how they vary by ethnicity, and how this impacts within the NHS.

Research highlights that Asian/Asian British and Chinese women experience the largest gender pay gap in the NHS at 21.3% and 20.9% respectively, followed by those of Mixed Ethnicity (13.5%), White women (6.1%) and women of Any Other Ethnic Background (2.1%). For Black/Black British staff, the gender pay gap is in favour of women (2.2%).

The report also highlights which inequalities to target. For example, policies directed at minimising the overall gender pay gap across all staff may do little to correct inequalities in gender pay that exist on other levels, such as within ethnic groups.

It is likely that the many complex factors that shape gender pay differences – such as occupational segregation, age, maternity and childcare, as well as cultural norms and direct discrimination – exert varying degrees of influence when it comes to different ethnic groups.

Burnt out doctors feel exhausted before they start a shift – GMC survey shows

The General Medical Council (GMC) has published the initial findings of its annual national training surveys which includes responses from more than 70,000 trainer and trainee doctors.

Key findings include:

  • nearly a quarter of trainee doctors say their work makes them feel ‘burnt out’;
  • almost one in three say they are often ‘exhausted’ in the morning at the thought of another shift;
  • almost half of trainees reported regularly working beyond their rostered hours, and around one in five say they often feel short of sleep while at work; and
  • trainers also reported heavy workloads, with a third saying it was hard to find time to fulfil their educational roles.

The GMC is now analysing the results in more detail to be published later in the year, and working with education providers to make sure improvements are made where training falls below expected standards.

Smokers discriminated against, in cost cutting bid

The British Lung Foundation (BLF) has published a report which warns that decommissioning stop smoking services across the country is discriminatory towards smokers, and puts at risk the future sustainability of the NHS if smokers are not able to get treated for their addiction.

The report’s main finding outlines that:

  • in England there was a 75% decline in the number of stop smoking aids dispensed in 2016/ 17 compared with 2005/6;
  • regional variation of Clinical Commissioning Group prescribing levels is huge. There are many areas where prescriptions are extremely low, even in areas with high numbers of smokers; and
  • smokers are discriminated against depending on where they live due to the commissioning choices made by local NHS bosses.

Alison Cook, Director of Policy for the BLF, said: “People who smoke are likely to be high users of NHS services. Decommissioning the prescribing of stop smoking aids will only achieve short-term savings. Worryingly, it will shore up a greater burden on the NHS in the long run in terms of hospital admissions and the impact on already stretched A&E services. The decisions are foolhardy and must be reversed.”

Caring for Carers

The Social Market Foundation has published a report which looks at the pressures faced by family carers that is not often put at the centre of conversations about the social care system.

It is estimated that there are 7.6 million carers over the age of 16 in the UK, and the average carer provides 19.5 hours per week. When scaled up nationally, this is equal to the work of four million full-time paid carers.

The report indicates that:

  • there are more women with caring responsibilities in the professional and managerial occupations;
  • the number of hours of care that family carers provide is rising overall;
  • the more hours of care a person provides, the more likely they are to reduce their hours of work or exit the workforce altogether; and
  • there should be much greater use of “care navigators” to help family carers through the complex system in public sector bodies overall package of care.

The report makes a number of recommendations for the Social Care Green Paper, which are aimed at employers offering more support for working carers.

Be Clear on Cancer campaign urges public to check urine for blood

PHE has released their latest ‘Be Clear on Cancer’ campaign which focusses on blood in the urine as a key symptom of bladder and kidney cancers. The campaign aims to encourage everyone to ‘look before they flush’ and visit their GP if they notice blood in their pee.

Prescribed medicines review: scope and terms of reference

PHE has published the scope and terms of reference of the review of the evidence for dependence on, and withdrawal from, prescribed medicines. The Parliamentary Under Secretary of State for Public Health and Primary Care commissioned Public Health England (PHE) to review the evidence for dependence on, and withdrawal from, prescribed medicines. The review was launched in January 2018 and is due to report in spring 2019.

The review will bring together the best available evidence on:

  • prevalence and prescribing patterns;
  • the nature and likely causes of dependence and the short-term discontinuation or longer term withdrawal symptoms associated with prescribed medicines among some people who take these medicines; and
  • effective prevention and treatment of dependence, withdrawal and discontinuation syndrome for each drug category

Included within the scope of the review are:

  • adults (age 18 and over);
  • dependence, withdrawal and discontinuation syndrome;
  • benzodiazepines, Z-drugs, GABA-ergic medicines, opioid pain medications, antidepressants; and
  • community prescribing.

SACN publishes ‘Feeding in the first year of life’ report

The Scientific Advisory Committee on Nutrition (SACN) has published a report which provides recommendations on infant feeding from birth up to 12 months of age.

The SACN recommends babies are exclusively breastfed until around 6 months of age and continue to be breastfed for at least the first year of life. Additionally, solid foods should not be introduced until around 6 months to benefit the child’s overall health. This represents no change to current government recommendations.

Other recommendations include:

  • breast milk, infant formula and water should be the only drinks offered between 6 and 12 months of age;
  • a wide range of solid foods, including foods containing iron, should be introduced from around 6 months of age, alongside breastfeeding; and
  • breastfed infants up to 12 months should receive a daily supplement containing 8.5 to 10µg of vitamin D (340-400 IU/d) – formula-fed infants do not need a supplement unless consuming less than 500ml of infant formula a day.

Learning disabilities and CQC inspection reports

The Care Quality Commission (CQC) has published an analysis of 30 acute trust inspections conducted in 2015. The report investigates the extent to which health care for people with learning disabilities is mentioned within CQC inspection reports.

The report has found that in comparison to the previous analysis in 2014, there was much better coverage of health care for learning disabilities.

Some issues for the CQC to consider arising from these findings were outlined as follows:

  • labelling reasonable adjustments;
  • audits;
  • the needs of people with autism;
  • alerts versus flagging systems; and
  • mental capacity.

Flu vaccine effectiveness in 2017 to 2018 season

Public Health England (PHE) has published data on the effectiveness of the flu vaccine in the 2017/18 season. Overall, the vaccine was 15% effective in all ages, but this varied considerably. By age-group, overall the vaccine was:

  • 26.9% effective in children aged 2-17 years (who received the nasal spray);
  • 12.22% effective in at-risk groups aged 10-64 years; and
  • 10.1% effective in those aged 65 and over.

There were higher levels of protection against flu B and H1N1pdm09, especially in children (60.8% effective against flu B and 90.3% against H1N1pdm09 in children).

In the 2018/19 season, a new vaccine is being made available for those aged 65 years and over, and the quadrivalent vaccine will be made available for all adults, aged between 16-64 years, in at-risk groups, which should provide better protection than current vaccines.

Media monitoring

On Monday 9th July 2018, the following stories were published:

  • Public health funding will continue to be cut despite the extra £20 billion pledged to the NHS. New research by the Health Foundation reveals that spending per head in England on programmes to tackle smoking, poor diet and alcohol abuse has fallen by 23.5% over the last five years. Featured in The Guardian.
  • Around one million older people are ‘badly let down’ by lack of social care funding. Age UK reveal that one in seven older people in England are left to get by on their own, without social care support. Featured in The Guardian, The Times and The Mirror.
  • In The Mail, medic Dr Max Pemberton suggests ‘the death of proper family GPs could be putting lives at risk’. The article notes that just half of patients have a regular doctor they see every consultation and that those who see the same doctor each time are far less likely to die.

On Wednesday 11th July 2018, the following stories were published:

  • The Times reports that Health Minister Steve Brine is warning that British children are consuming 50% more energy drinks than the European average and their health is suffering as a consequence. The Government plans to consult on a ban on children buying these drinks as part of its childhood obesity plan. Also covered by The Sun and The Mail.
  • The Sun reports that GPs have given out one million fewer prescriptions since the NHS released guidance on stopping the prescribing of ‘wasteful’ treatments.
  • The Mail has a piece from a doctor who believes GPs should be able to prescribe creative courses for depressed patients. It is suggested that this could help reduce the £266 million annual NHS bill for anti-depressants.
  • The Times reports that taking vitamins and supplements that claim to promote cardiovascular health won’t prevent heart attacks. A study involving more than two million people found that the most common health supplements are ‘at best a distraction’. Also covered by The Independent, The Sun, The Express and The Mail.

On Thursday 12th July 2018, the following stories were published:

  • The Independent reports that the NHS remains “stubbornly attached” to fax machines, according to the Royal College of Surgeons (RCS). An FOI request revealed that health trusts in England own almost 9,000 of them and the RCS is warning that the NHS shouldn’t be relying on a technology that most other organisations scrapped in the early 2000s. There is also some concern raised about how it may risk patient records not being up-to-date. Also covered by The Telegraph, The Times, The Sun, The Mail and iNews.
  • The Mail and The Express report that Public Health England figures show that scarlet fever is at its highest levels in nearly 60 years.
  • A study has found that eating a healthier diet can reduce asthma symptoms by up to a third, reports iNews and The Express.

On Friday 13th July 2018, the following story was published:

  • The number of patients in England who have been forced to wait six months or longer for NHS treatment has risen by nearly 70,000 in the space of a year, official figures showed. More than 211,000 people have been waiting since before Christmas for operations or treatment, an increase of 48% on the same NHS England figures from 2017. Featured in The Independent and The Mail.

On Saturday 14th, Sunday 15th and Monday 16th July 2018, the following stories were published:

  • Heatwave causes spike in insect bite calls to the NHS 111 helpline. Featured in the BBC, Independent and Sun.
  • Increase in sleeping problems due to UK’s longest heatwave in 40 years. Reported in The Guardian.

On Tuesday 17th July 2018, the following story was published:

  • The British Heart Foundation is warning that patients who have heart disease as well as another long-term condition are not being adequately catered for by the NHS, reports The Express and The Guardian.

On Wednesday 18th July 2018, the following stories were published:

  • Thousands of patients are unable to see an NHS dentists due to a recruitment crisis, reports The Mail. One of the UK’s largest providers, with 650 practices, is struggling to fill posts due to a national shortage of dentists.
  • The Independent reports that a major study has found that omega-3 supplements do nothing to prevent heart attacks or stroke.
  • The Mirror and The Express report that cases of norovirus have broken out across the country.

On Thursday 19th July 2018, the following stories were published:

  • Asthma deaths rise 25% amid growing air pollution crisis. In England and Wales 1,320 people died of asthma last year, a rise of more than 25% over a decade, according to data from the ONS. Featured in The Guardian.
  • The Joint Committee on Vaccination and Immunisation has formally recommended that the HPV vaccination should be offered to males. Featured in The Telegraph, The Mail and iNews.
  • The Sun and The Mail report Viagra sales have soared since the drug has been available to buy over-the-counter in pharmacies.
  • People living in the poorest parts of the UK are more likely to die prematurely, reports the BBC. The BBC’s Shared Data Unit analysed data from the Office for National Statistics with deprivation data for local authority areas and found a strong correlation between deprivation and the number of people dying prematurely.

On Friday 20th July 2018, the following story was published:

  • Pulse Magazine report that a fifth of GP appointments are potentially avoidable, according to an audit funded by NHS England. The audit found that of the avoidable appointments 7.5% could have been seen by another clinician in the practice and 4.2% could have been met by another local service.


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