Health & Care Review

Health & Care Review

February 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.

Refreshing NHS Plans for 2018/19

NHS England and NHS Improvement have published joint guidance aimed at commissioners and providers in updating their 2018/19 operational plans. The guidance aims to enable organisations to continue to work together through Sustainability and Transformation Partnerships to develop system-wide plans to improve services and manage within collective budgets.

The guidance covers the financial framework; planning assumptions for emergency care and Referral to Treatment Times; delivery of Next Steps priorities; and integrated system working.

Adult social care workforce statistics released by NHS Digital

NHS Digital has published new statistics relating to adult social care staff who work for local authorities (LAs) in England.

Key statistics include:

  • as of September 2017, there were 109,300 adult social services jobs in LAs (held by around 105,300 people), a decrease of 50,100 LA jobs since 2011;
  • the most commonly cited reasons for these decreases were restructures and service closures; and
  • between 2016 and 2017, the 3% decrease in adult social services jobs in LAs has been the lowest year on year change since 2011.

The adult social care workforce in England

The National Audit Office has published a report which considers the role of the Department of Health and Social Care (DHSC) in overseeing the adult social care workforce. It also assesses whether the size and structure of the care workforce are adequate to meet the needs of users in the face of financial challenges and a competitive labour market.

Key problems identified in the report include:

  • turnover and vacancy rates: two roles in particular – care workers and registered nurses – have high vacancy and turnover rates compared with other roles within social care. High vacancy rates and turnover can disrupt the continuity and quality of care for service users and also mean providers incur regular recruitment and induction costs;
  • care work is viewed by the public as low skilled and offering limited opportunities for career progression;
  • the vacancy rate for nurses more than doubled between 2012/13 and 2016/17; and
  • DHSH does not have an up-to-date care workforce strategy and roles and responsibilities of the bodies involved in delivering care are not clear.

The report also makes recommendations to ensure there is a care workforce that is suitably planned, supported and resourced to improve the quality of care and alleviate pressures on the health service.

NHS Health Check: stocktake and action plan

Public Health England (PHE) has published a stocktake and action plan to set out the main areas for development for PHE, LAs and NHS England gain maximum benefit from the NHS Health Check programme.

This set of slides reviews the programme as the first 5-year cycle ends and outlines an action plan for the next cycle focusing on:

  • delivering a high-quality programme;
  • encouraging the development of evidence and research;
  • providing strong leadership; and
  • maximising access to and utility of intelligence.

Using digital technology to improve the public’s health: a guide for local authorities

The Local Government Association has published a guide on how digital technology can be used to improve the public’s health. The guide provides an overview of what is happening locally and features case studies of how local areas have implemented digital approaches to public health. These include in Hertfordshire, wearable sensors worn during an exercise class have allowed for a quick and accurate assessment of an individual’s fall risk instead of a half hour assessment taking place. In North East London, a pilot where pharmacies used a handheld mobile device to test for irregular heartbeats has reduced the time from testing to treatment from 12 weeks to under three.

Commissioner Sustainability Fund and financial control totals for 2018/19: guidance

NHS England has published a guidance document which outlines details of a targeted Commissioner Sustainability Fund (CSF) to support CCGs that would otherwise be unable to live within their means for 2018/19. The CSF is designed to help certain CCGs to return to in-year financial balance, whilst supporting and incentivising CCGs to deliver against their financial control totals.

CSF funding totalling up to £400 million will be allocated to fund in-year CCG deficits in 2018/19. If the amount required to fund CCG deficits is less than £400 million, the balance will be held in reserve by NHS England to cover any further pressures arising during the year.

Tackle falling nursing applications now, urges RCN

The Royal College of Nursing (RCN) has published a new report, Left to chance: the health and care nursing workforce supply in England which looks at nursing application figures from the Universities and Colleges Admissions Service (UCAS).

The report warns that according to UCAS data, the current number of applications for the next academic year has fallen by a third since the same point in 2016, and by 13% since last year.

As a result, the RCN says urgent action is needed to prevent the staffing crisis from getting even worse.

Statistics on Drug Misuse: England, 2018

NHS Digital has published a statistical report relating to drug use in children and adults in England.

Key statistics highlighted include:

  • there were 7,545 hospital admissions with a primary diagnosis of drug-related mental health and behavioural disorders. This is 12% lower than 2015/16 but 12% higher than 2006/07;
  • in 2016 there were 2,593 registered deaths in England and Wales related to drug misuse. This is an increase of 5% on 2015 and 58% higher than 2006;
  • in 2016/17, 8.5% of adults aged 16 to 59 in England and Wales had taken an illicit drug in the last year; and
  • in 2016, 24% of pupils reported they had ever taken drugs. This compares to 15% in 2014.

Suicide Prevention: Policy and Strategy

The House of Commons Library has published a briefing which looks at suicides in the UK, and also discusses current suicide prevention policies and strategies. These include health services; education; employment and social security; railways and media.

Key facts include:

  • suicide prevention policy in the UK has, in recent decades, developed and expanded considerably as concerns around suicide rates have intensified;
  • in Great Britain in 2016, there were 5,668 deaths where the cause was identified as suicide; and
  • men are three times more likely than women to take their own lives, and this gender gap has grown in the past 35 years.

While this paper focuses heavily on policies relating to England, it also considers suicide prevention strategies developed and implemented by the governments of Scotland and Wales, as well as the Northern Ireland Executive.

Homeless adults with complex needs: evidence review

PHE has published an evidence review on adults with complex needs, with a particular focus on people begging or living on the streets.

The purpose of the review is to provide an overview of the national picture in relation to homelessness and provide insights into the current evidence base to support action for prevention. It is aimed at local authorities and other stakeholders who are developing strategies and interventions to prevent homelessness and support adults with complex needs.

The report concludes that although there are a number of interventions which are promising in terms of reducing and preventing homelessness, there is no single intervention that will solve the complex issues surrounding homelessness. There needs to be a whole system approach to ensure services developed meet the needs of those who require them.

HPV vaccination for men who have sex with men: year 1 pilot

PHE has published an evaluation of the first year of the human papillomavirus vaccination programme pilot for men who have sex with men (MSM). The pilot used data from clinical recording systems and a survey of individuals receiving the vaccine, together with feedback from clinics and sexual health commissioners in 2016 to 2017.

The first review of the pilot demonstrated that such a programme can be delivered opportunistically in an acceptable and, as far as can be evaluated, equitable manner, without major disruption to Genito-Urinary Medicine and Human Immunodeficiency Virus clinics.

PHE launches opioid treatment quality improvement programme

PHE has announced that it will be launching a new opioid substitution treatment (OST) programme to support services to improve the quality of treatment and increase chances of recovery. The programme will include a focus on psychosocial interventions as well as enhance wider recovery support such as employment, living arrangements, family relationships, trauma and abuse.

PHE urges vigilance about spotting signs of scarlet fever

PHE has published a news article to raise awareness on the signs and symptoms of scarlet fever among parents of children. This follows reports of a substantial increase in cases across England in 2017 to 2018.

The latest Health Protection Report showed 6,225 cases of scarlet fever had been reported since mid-September 2017, compared to 3,764 for the same period last season. There were 719 cases reported for 22-28th January 2018.

Health charge for temporary migrants will increase to £400 a year

DHSC has announced plans to increase the immigration health surcharge paid by temporary migrants in the UK from £200 to £400 per year. The discounted rate for students and those on the Youth Mobility Scheme will increase from £150 to £300.

Health Minister James O’Shaughnessy said: “By increasing the surcharge so that it better reflects the actual costs of using health services, this government is providing an extra £220 million a year to support the NHS.”

Funding boost for new mums’ mental health

NHS England has announced that funding worth £23 million will be made available to improve the mental health of at least 3,000 pregnant women and those who have recently given birth.

The funding is part of the perinatal mental health community services development fund which will see a total of 30,000 additional women getting specialist mental health care, in person and through online consultations.

Media monitoring

On Monday 5th February 2018, the following articles were published:

  • The British Dental Association is warning that a recruitment crisis means patients are facing longer journeys to see an NHS dentist for treatment, reports The Telegraph.
  • The Express warns of an impending liver disease crisis as an investigation revealed a 52% jump in NHS diabetes medication prescriptions – a key cause of non-alcoholic fatty liver disease – since 2010/11.

On Tuesday 6th February 2018, the following articles were published:

  • Public Health England (PHE) is calling for e-cigarettes to be available via NHS prescription and in hospitals to help more people to quit smoking, says The Independent.
  • PHE also wants the Government to make it easier for manufacturers to license e-cigarettes as medical devices. This story was also covered by the BBC, Times, Telegraph, Guardian, Daily Mail, Mirror and Sun.
  • The Express reports that a daily dose of aspirin could cut your risk of getting certain types of cancer by 10%. Cancer Research UK has launched a study to find out how it prevents cancer, and what dose is needed to be most effective.

On Wednesday 7th February 2018, the following articles were published:

  • The Times reports that Jeremy Hunt has announced a review of criminalising doctors.
  •  From April, gay men will be offered the HPV vaccine when they attend sexual health screenings, says The Independent. It has previously only be offered to girls aged 11 to 13. This story was also covered by The Mail.

On Thursday 8th February 2018, the following articles were published:

  • Spending just 10 minutes a day talking to people with dementia about their interests or family could help improve their quality of life, according to a study reported by iNews and the BBC.
  • School programmes encouraging children to take more exercise and eat healthily are unlikely to have any real effect on childhood obesity, report iNews, the Times and BBC. On a similar topic, the Guardian reports that half of all the food bought by families in the UK is now “ultra-processed”.
  • The BBC reports on growing evidence that diet could have an impact on the growth and spread of cancer. This was also reported by the SunExpressIndependent, iNews and the Times.
  • Ibuprofen taken by women in their first three months of pregnancy might reduce a daughter’s number of eggs, potentially affecting the child’s future fertility, according to the Guardian.
  • People who use electronic cigarettes are more vulnerable to pneumonia, warn the TelegraphMail and the Mirror. But PHE says hospitals should stock e-cigarettes for sale to patients, according to the Independent.
  • Low alcohol drinks could be encouraging people to drink more frequently, reports the Telegraph.

On Friday 9th February 2018, the following articles were published:

  • The Guardian reports on a study suggesting that there is no need for an upper limit to folic acid intake.
  • A study has found significant associations between the increased walkability of a neighbourhood, lower blood pressure and reduced hypertension risk among its residents, the Guardian reports.
  • The Sun warns of addiction dangers for young people after figures show that the UK is the second-largest black market for Xanax in the world, after the US. The Guardian also reported on this, citing online pharmacies as a possible source of the medicines.

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