Health & Care Review

Health & Care Review

May 1, 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.

GMC gears up to support extra international doctors wanting to work in the UK

The General Medical Council (GMC) is adapting to meet increased demand in the number of non-European Union doctors applying to take the practical exam in order to work in the UK.

The GMC is adding additional test dates at weekends to support a healthy supply of doctors into UK practice. The GMC is expecting more than 5,000 doctors to take the exam this year.

The rising cost of medicines to the NHS: what’s the story?

The King’s Fund has published a briefing which examines total spends on medicines by the health service. The briefing also explores policies used to try to control growth in costs and the future choices likely to be faced by policymakers.

Key facts include:

  • estimated total NHS spending on medicines in England has grown from £13 billion in 2010/11 to £17.4 billion in 2016/17 – an average growth of around 5% per year;
  • much of the recent growth in medicines spending has been in the hospital sector, where estimated costs have grown at 12% a year on average since 2010/11;
  • in primary care, spending growth is lower. Although the volume of prescription items increased by almost half in the decade to 2016, this was offset by a reduction of nearly a quarter in the average cost per prescription item; and
  • without a new funding settlement for the NHS, policymakers are likely to face increasingly difficult choices.

Prevalence of beliefs about actual and mythical causes of cancer

Cancer Research UK has published the findings of a research piece it commissioned, published in European Journal of Cancer.

Researchers at University College London and the University of Leeds surveyed 1,330 people in England and found that more than 40% wrongly thought that stress (43%) and food additives (42%) caused cancer.

A third incorrectly believed that electromagnetic frequencies (35%) and eating GM food (34%) were risk factors, while 19% thought microwave ovens and 15% said drinking from plastic bottles caused cancer despite a lack of good scientific evidence.

Among the proven causes of cancer, 88% of people correctly selected smoking, 80% picked passive smoking and 60% said sunburn.

The research paper concludes that awareness of actual and mythical cancer causes is poor in the general population. Only knowledge of established risk factors is associated with adherence to behavioural recommendations for reducing cancer risk.

Patient-centred care for older people with complex needs: Evaluation of a new care model in outer east London

The Nuffield Trust has published an evaluation of a ‘one-stop’ primary care service within three London boroughs: Barking and Dagenham, Havering and Redbridge, for older people with complex health care needs.

The care model, known as ‘Health 1000’ was dedicated to addressing the health and social care of patients with complex needs utilising a multidisciplinary team, focussing on prevention and early intervention. It was also supported by contributions from the third sector. The original plans were for a service that catered for 1000 patients, but fewer than half that number were registered over two-and-a-half years.

The evaluation suggest that primary care hubs dedicated to the care of older people with complex needs could have a positive impact on quality of care, and on the experiences of both patients and staff. However, there was no evidence that these benefits translated into reduced use of hospitals although this could have been due to the timescale and numbers of patients which could have been too soon to see any effect.

NHS action on sugar pays dividends as hospitals slash unhealthy food and drink sales

NHS England has provided an update ahead of the upcoming sugar tax and has reported a sharp decline in the sales of sugar snacks and drinks from hospitals and their outlets.

So far, 152 of the 232 NHS trusts have signed up to the scheme. Headline results show a decline in chocolate bar sales, increase in fruit sales and running healthy meal deals which include sandwiches under 400 calories.

Innovation and technology in the NHS

Launched at the NHS Confederation conference by Simon Stevens on 15 June 2017 and as part of NHS England’s commitment to the NHS Five Year Forward View (5YFV), NHS England has developed the Innovation and Technology Payment (ITP) 2018/19.

The aim of the ITP is to help deliver on the commitment detailed within the NHS 5YFV– creating the conditions and cultural change necessary for proven innovations to be adopted faster and more systematically through the NHS, and to deliver examples into practice for demonstrable patient and population benefit.

NHS England has identified successful innovation or technology themes through a competitive process and the four innovations on this year’s Innovation and Technology Payment are:

  • HeartFlow – advanced imaging software which created a 3D model of the coronary arteries to rapidly diagnose patients with suspect coronary artery disease avoiding the need for invasive invesigations;
  • Plus Sutures – a new type of surgical antimicrobial suture pack that reduces the rate of infections such as MRSA;
  • Endocuff Vision – a new type of ‘bowel scope’ that improves colorectal examination for patients undergoing bowel cancer tests; and
  • SecurAcath – a device to secure catheters that reduces infection risk for patients with a peripherally inserted catheter reducing the time taken to care and treat dressing changes.

Additionally, in an effort to tackle the problem of missed hospital appointments, NHS England will support DrDoctor, a digital tool to help patients view, change and re-schedule appointments, to demonstrate its potential in a real world setting.

National pledge to stop overmedication for people with a learning disability, autism or both

NHS England is asking more doctors and healthcare professionals to sign up to a pledge to stop the overmedication of people with a learning disability, autism or both.

The drive is to support the Government-backed campaign, Stopping OverMedication of People with a Learning Disability (STOMP) which targets NHS trusts, Clinical Commissioning Groups and those in the independent sector. It is asking healthcare professionals to review and seek alternatives to prescribing psychotropic drug prescriptions.

The STOMP pledge was launched in June 2016 supported by a number of professional bodies including the Royal Colleges of Nursing, Psychiatrists and GPs, as well as the Royal Pharmaceutical Society, the British Psychological Society and the Challenging Behaviour Foundation (CBF).

So far, more than 60 providers supporting nearly 60,000 people have signed up to the pledge. NHS England now wants all healthcare professionals to commit to the STOMP pledge.

Healthier You: NHS Diabetes Prevention Programme fact sheet

NHS England has published a factsheet to provide more details on the NHS Diabetes Prevention Programme.

The factsheet provides key stats of the programme, such as:

  • there will be 100% coverage across England in 2018/19;
  • 50% conversion rate from referral to initial assessment;
  • 3.7kg average weight loss;
  • 25% of patients enrolled on to the programme were from a Black or Minor Ethnic group, and 45% were under the age of 65; and
  • 44% of patients enrolled on the programme are men – a much higher proportion than typically attend commercial weight loss programmes.

The Lord Darzi Review of Health and Care: Interim report

The Progressive Policy Think Tank has published an interim report on a review by Lord Darzi which examines the state of quality in health and care services on the NHS’s 70th birthday. The review was launched in December 2017 and includes recommendations for future funding and reform.

The final report will be published in the lead up to the 70th anniversary and will set out a long term funding and reform plan for health and care.

The five conclusions of the interim review are:

  • the health and care system has done exceedingly well to maintain or increase quality in the context of austerity;
  • the main sources of increased productivity are running out of road the system’s ability to find other sources of revenue funding is increasingly limited;
  • Governments must stop approaching the NHS and social care as a liability to be managed and instead look at it as an investment that delivers a return – good health is an asset; and
  • Money alone is not enough – a bold reform plan is needed if thehealth and care system is to be fit for the 21st century.
  • Recognise that there is no “magic money tree” and be clear where money is coming from but most importantly building on the process made of the quality of care in health and care.

Media monitoring

On Monday 23rd April 2018 the following stories were published:

  • The Government has announced £6 million of funding to support children with alcoholic parents, reports the BBC. Plans include programmes to treat parents’ addiction and local councils will be able to bid for a share of the funding.
  • Public Health England are warning people to protect themselves from measles as more than 250 cases have been reported since the start of the year, reports The Telegraph. It is thought to be linked to a series of outbreaks in Europe. Also covered by The Express.
  • The BBC reports that man in the UK who caught the worlds ‘worst-ever’ case of super-gonorrhoea has been cured. It was the first case of the infection being incurable with first choice antibiotics, but now two similar cases have been reported in Australia. Also covered by The Mail.

On Tuesday 24th April 2018 the following stories were published:

  • NHS England faces a legal challenge over the introduction of Accountable Care Organisations, reports The Guardian. Campaigners say the plans could force doctors to decide what care a patient needs based on how much money is available rather than how sick someone is. Also covered by Sky News.
  • The Mail reports on the prevalence of so-called ‘never events’ at NHS hospitals. There were more than 430 of these serious patient safety incidents between April 2017 and March 2018.

On Wednesday 25th April 2018 the following stories were published:

  • Brexit blamed as record number of EU nurses give up on Britain, reports The Guardian. The number of departures was 28% more than in 2016/17.
  • Pioneering prostate treatment for tens of thousands of men gets NHS green light, reports The Telegraph. Tens of thousands of men could be spared major surgery after NHS watchdogs have approved the new technique to treat one of the most common medical complaints facing older men. Also featured in the BBC.
  • E-cigarettes are in danger of becoming ‘lifestyle choice’ before safety is proven, warns health professor. The Telegraph features an article discussing the use of e-cigarettes. Professor Leng, of NICE, questioned whether e-cigarettes are being marketed as a lifestyle choice rather than a quitting aid.

On Friday 27th April 2018 the following stories were published:

  • Migrant rules ‘leaving NHS short of doctors’ reports the BBC. Immigration rules are hampering the ability of the NHS to recruit doctors, health leaders are warning. The number of skilled non-EU workers granted UK visas is capped, with the Home Office arguing the restriction is in ‘the national interest’. But NHS bosses say increasing numbers of doctors are being refused permission, worsening rota gaps and the waits patients face for treatment. Also reported in The Telegraph, The Mail and The Times.

  • NHS patients to monitor heart disease and diabetes at home within ten years thanks to artificial intelligence, reports The Sun.


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