Health & Care Review

Health & Care Review

May 14, 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 system launched to help measure and prevent medication errors

The Department of Health and Social Care (DHSC) has launched a new system to help the NHS monitor, learn from and prevent costly medication errors through linking prescribing data in primary care to hospital admissions. The series of indicators will inform safer prescribing practice and has been launched following the recent publication of research which highlighted the impact of medication errors. The indicators are intended to help pharmacists, clinicians and patients to review prescribed medication and prevent avoidable harm.

The report of the Short Life Working Group on reducing medication related harm made a series of recommendations which included quantifying prescribing practice that has a higher risk of harm and is associated with hospital admission.

The indicators aim to:

  • support local reviews of prescribing;
  • minimise unnecessary prescribing;
  • identify where alternative medicines or medicines that reduce the risk could be prescribed; and
  • reduce the number of patients who are potentially at risk of harm from medicines and the number of hospital admissions associated with that risk.

Professionals registered with ePACT2 can access prescription level data. Other users should access the data using the medication safety dashboard. This is an open access service that aims to improve quality, patient outcomes and value from medicines use.

Jeremy Hunt orders urgent action on patient safety at independent hospitals

The Health and Social Care Secretary has written a letter to chief executives of leading independent healthcare providers ordering them to take urgent action to improve patient safety. The letter follows a Care Quality Commission report on the sector which found that a third of independent hospitals were rated as ‘requires improvement’ due to examples of poor practice and unsafe care.

The letter contains a number of safety and quality issues which independent care provers are asked to co-operate on within two weeks, such as transparency, negligence costs, critical care and transfers to the NHS.

Transformational change in health and care: reports from the field

The King’s Fund has published a report which offers insight on transformational change, from four selected sites recognised as successful transformation initiatives.

The report features case studies from London, Birmingham and Solihull, Northumbria and one from the Netherlands. The authors of the report interviewed 42 people who were involved in leading, supporting, delivering, receiving or witnessing the changes that informs the report.

Each case study describes the approach they followed to achieve transformational change, the challenges they faced, the opportunities, the need for transformational leadership and the collective focus required.

Spending on and availability of health care resources: how does the UK compare to other countries?

The King’s Fund has published a briefing which examines how much the UK spends on health care in comparison to other countries, and how the NHS is utilising some of the key resources this spending pays for.

The briefing specifically looks at workforce, bed capacity, medical technology, medicines and funding.

Key facts in the briefing include:

  • the UK has fewer doctors and nurses per head of population than almost all the other countries examined;
  • the UK has fewer magnetic resonance imaging and computed tomography scanners in relation to its population than any of the other countries examined;
  • Only two countries had fewer hospital beds per head of population than the UK, while the UK also has fewer beds in residential care settings than comparator countries.
  • the UK spends less on medicines than most of the other countries examined; a key reason for this is the success of initiatives to improve the value of expenditure on medicines, such as encouraging the use of generic drugs; and
  • the NHS is under-resourced compared to other countries and lags a long way behind other high-performing health systems in many key areas of health care resources.

The 10-year strategy for the health and care workforce

The King’s Fund has published a report based on a roundtable event it co-hosted with the Nuffield Trust and the Health Foundation to help inform and shape Health Education England’s workforce strategy. The draft strategy consultation document, Facing the facts, shaping the future, was published in December 2017 and will be followed by the final strategy in summer 2018.

Key messages from the roundtable discussion include:

  • there is more than the NHS being a good employer. Given the time it takes to train new staff, reducing the current number of people leaving the professionals, early retirements and staff turnover is likely to provide benefits to everyone;
  • much of the social care workforce is low paid, unregistered and employed in small private sector organisations; and
  • the future workforce is difficult to model as current models are continuously evolving, and it has to be thought through in terms of what staff to train in the future but also how continuing professional development and re-training can allow greater flexibility once people are trained.

RSPH and ukactive recognise exercise professionals in the wider public health workforce

The Royal Society for Public Health has published a joint report with ukactive that focusses on how to enhance the exercise professional workforce and how it can play an enhanced role in supporting the public’s health. The exercise professional workforce represents roles such as fitness instructors, group exercise instructors and personal trainers working outside of sporting contexts and within the fitness industry. There are approximately 57,000 members in the UK workforce.

Key findings in the report include:

  • the overwhelming majority (85%) of exercise professionals already talk to their clients about wider health and wellbeing issues beyond physical fitness;
  • there is a strong appetite from professionals and the public alike for a greater public health role for the exercise professional workforce: 81% of exercise professionals saying they would be willing to deliver advice on a broader range of health issues, and a significant proportion of the public saying that would be comfortable receiving health advice from personal trainers (83%) and group exercise leaders (74%);
  • the main barriers identified by professionals to this enhanced role are lack of strong links with local health professionals (66%), limited financial support for training (58%), and communication skills (56%); and
  • there is some support among the public for the co-location of health services within fitness facilities, primarily smoking cessation services (51%) and GP drop-in services (53%).

Credible plan to sustain underfunded care sector needed this year

The Public Accounts Committee has published a report which warns that urgent action is required to reverse care work’s poor public image and boost staff recruitment and retention.

The Committee has highlighted that the social care sector is underfunded, with the care workforce suffering from low pay, low esteem and high staff turnover. Additionally, the lack of regulation within the care sector workforce and the balance of regulation vs a market based approach is not supporting the sector to provide the best care possible.

The UK’s departure from the European Union is causing uncertainty over workforce sustainability, particularly in areas more reliant on non-UK workers. There is an urgent need to reverse the poor public image that care work has to boost recruitment and retention across the care sector.

The Committee also outlined its concern that the focus on critical care needs only is contributing to growing levels of unmet need for people with moderate care needs.

DHSC has committed to addressing these issues through the health and workforce strategy that it is currently consulting upon, and the promised Green Paper on funding of care for older adults.

London Mayor plans junk food ad ban on public transport

Mayor of London Sadiq Khan has revealed plans to impose a ban on junk food advertising on public transport, in a bid to tackle childhood obesity.

The plans, which are currently being consulted upon, are part of Mayor Khan’s wider London Food strategy that aims to help Londoners make healthier food choices over the next 10 years. The proposals include potentially seeing adverts for unhealthy food and drink that are high in fat, salt or sugar banned across the entire Transport for London network, including London Underground, Overground and the capital’s buses and bus shelters.

The Mayor said the measures are designed to tackle the “ticking timebomb” of childhood obesity in the capital.

Media monitoring

On Tuesday 8th May 2018 the following stories were published:

  • The Times reports that the Royal College of GPs want receptionists and admin staff to be trained in ‘social prescribing’ to ease the pressure on GPs. This would involve referring people to yoga, walking groups and debit advisers. Also covered by The Telegraph.
  • The Sun reports that 6,000 fingerprint scanners are to be given to GP practices and clinics to detect patients with irregular heart rhythms, hopefully saving £81 million in associated costs.

On Wednesday 9th May 2018 the following stories were published:

  • The Mail and the BBC report that NICE says there is not good enough evidence to recommend that people with an STI drink cranberry juice. NICE also says that it may be appropriate for patients who need antibiotics to have a ‘back-up prescription’ which should only be used if symptoms do not improve within 48 hours.
  • Patients’ ability to see the GP they want has declined by 27% over five years, despite government pledges to improve continuity of care. Evidence shows that people who see the same GP when they go to the surgery are more likely to have an ailment diagnosed early, take prescribed medications and access services to prevent ill health. Featured in iNews, The Telegraph, The Sun, The Times, The Mail and The Guardian.

On Thursday 10th May 2018 the following stories were published:

  • The Mail reports that NHS staff responding to 999 calls will assess patients using video before an ambulance is dispatched. The BBC says the new app is being trialled by air ambulance medics. Also covered by the Telegraph and Times.
  • The Guardian reports that the NHS will no longer have to share immigrants’ data with the Home Office. There had been concerns from doctors’ groups and health charities that the practice was a barrier to some people seeking medical help. Also covered by the Independent, Telegraph, Times, Mail, and the BBC.
  • A few papers contain opinion pieces following on from yesterday’s news that patients are finding harder to see the same GP. The Guardian features a piece from the former chair of RCGP Clare Gerada, and iNews features one from their assistant editor for wellbeing.

On Friday 11th May 2018 the following stories were published:

  • More than 1.5 million heart flutter patients should be on blood-thinning drugs to prevent stroke, study says. The Telegraph features research which has found that even patients whose atrial fibrillation appears to have improved have a significantly increased risk of stroke, and that doctors are too quick to take people off anticoagulants once symptoms have gone away. The new research suggests around 130,000 high-risk patients are not receiving the drugs they need.
  • NHS staff will soon be able to sign up for extra shifts using an app to help cut agency costs, reports The Mail. An app which allows NHS workers to book onto empty shifts could be rolled out across the country to reduce reliance on ‘expensive agency staff’. Also featured in ITV News.
  • Immigrants working for the NHS should get special visa category after Brexit, says Jeremy Hunt. The Mail reports that the Health Secretary has said he is likely to lobby for a dedicated visa for immigrants working for the NHS, enabling them to stay in the UK.
  • New skincare brand to provide free hand care to NHS nurses and midwives. New brand Nursem offers a hand cream designed to protect nurses from discomfort caused by excessive hand washing. Nursem aims to provide free hand cream to all NHS nurses and midwives by 2025. Featured in The Metro.

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