Health & Care Review

Health & Care Review

May 22, 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 polling highlights public priorities for health and care funding

NHS Clinical Commissioners (NHS CC) has published the findings of a poll, commissioned by NHS Providers, NHS CC, the Royal College of Physicians and National Voices ahead of a major debate to mark the NHS’s 70th birthday. The poll was undertaken by telephone with a representative sample of 917 adults aged 18+ in England between 26th – 29th April 2018.

The findings suggest that emergency services and mental health care are the public’s top priorities for any extra funding for health and care.

Key findings include:

  • the number of respondents who believe that NHS performance will get ‘much better’ or ‘better’ has increased to 21%, up from 15% for the previous year;
  • the number of respondents who believe that the NHS will get ‘worse’ or ‘much worse’ has fallen to 46%, down from 62% the previous year; and
  • only 11% of respondents cited ‘being treated close to my home’ as a priority when receiving non-emergency care, which suggests that receiving a high quality of care is more important than the distance travelled to receive care.

Promoting health and preventing premature mortality in black, Asian and other minority ethnic groups

The National Institute for Health and Care Excellence (NICE) has published a quality standard which covers promoting health and preventing premature mortality among black, Asian and other minority ethnic groups. It draws attention to specific areas of inequality and aims to support public authorities in considering their equality duty when designing, planning and delivering services.

The quality statements include that people from black, Asian and minority ethnic groups:

  • have their views represented in setting priorities and designing local health and wellbeing programmes;
  • are represented in peer and lay roles within local health and wellbeing programmes;
  • at high risk of type 2 diabetes are referred to intensive lifestyle change programme;
  • referred to a cardiac rehabilitation programme are given a choice of times and settings for sessions and are followed up if they do not attend;
  • can access mental health services in a variety of community settings; and
  • with a serious mental illness have a physical health assessment at least annually.

Short-staffed sexual health clinics turn people away

The Royal College of Nursing (RCN) has launched a new report in which it is suggested that the public are being left unprotected due to staffing shortages at sexual health clinics.

The report brings together the results of the RCN survey with nurses working in sexual and reproductive health; the data is presented alongside evidence from various other stakeholders.

Key facts include:

  • over five years, the number of 18-24 year olds being tested for chlamydia has fallen by almost half a million;
  • recent figures show a higher level of positive diagnoses for chlamydia now at 128,000 cases per year and a 12% increase in syphilis diagnoses;
  • over 600 nurses working in the field found services severely understaffed, with few registered nurses, an inadequate skill mix and little access to training; and
  • nurses reported having to turn patients away, a lack of clinics and described low morale and a tick box culture.

The RCN makes four recommendations that focus on:

  1. understanding where the education and training resources and provision are across England and where the gaps are;
  2. working with other stakeholders to clarify the requirements and opportunities for nurses to specialise in sexual and reproductive health;
  3. working with other stakeholders to develop quality standards for the development of online sexual and reproductive health; and
  4. continuing to lobby on the impact of budgetary cuts to sexual health provision and wider public health services.

Mapping winter in the NHS

NHS Providers has published a report to highlight the scale of pressures faced by NHS trusts and front line staff through the toughest winter on record.

Key facts in the report include:

  • the number of people coming to A&E over the winter period (between December 2017 and March 2018) rose to more than 5.8 million;
  • 160,000 more patients were admitted, transferred or discharge within the four hour target compared to the previous winter;
  • A&E attendances over the year rose to nearly 24 million – equivalent to almost half the population in England;
  • There were 1.52 million emergency admissions over the winter, an increase of 85,000 compared to the previous year; and
  • The number delayed by more than 15 minutes (the official limit) in handing patients over from the ambulance to hospital was 600,000.

The report also calls for a new planning framework based on realistic demand projections, and a review of capacity right across the health and care system in good time for next winter.

A fork in the road: next steps for social care funding reform

The King’s Fund has published a paper which pulls together new financial modelling, public perceptions work and policy analysis to identify the problems with adult social care in England. The paper outlines options for its reform and identifies the advantages, disadvantages, impact and consequences of each option.

The paper concludes that reforming the current system will be expensive, but that if reform is chosen, England is now at a clear ‘fork in the road’ between a better means-tested system and one that is more like the NHS; free at the point of use for those who need it.

Stress: are we coping?

The Mental Health Foundation has published a report, based on a new survey undertaken in 2018, that looks at the prevalence of stress in the UK and its implications. It focusses on what we can do to manage and reduce stress and makes recommendations for the Government in creating a stress-free environment.

Key facts highlighted in the report include:

  • 74% of people have at some point felt so stressed that they felt overwhelmed or unable to cope;
  • 51% of adults who felt stressed reported feeling depressed and 61% reported feeling anxious;
  • of the adults who said they had felt stress at some point in their lives, 16% said they had self-harmed, and 32% said they had suicidal thoughts and feelings.

RCGP calls on government to facilitate ‘social prescribing’ for all practices

The Royal College of General Practitioners (RCGP) has published a report which suggests that every GP surgery should be funded to have access to a dedicated social prescriber.

The report assesses NHS England’s Time for Care Programme – specifically, its 10 High Impact Actions, which aim to cut workload in general practice.

Of the 10 High Impact Actions evaluated, the RCGP found that the recommendation to utilise social prescribing – the practice of referring patients to non-medical care – to be one of the most effective and beneficial for both GP teams and patients.

This has led to the RCGP’s call for every practice to be equipped with access to a dedicated social prescriber to help patients find the right care.

Tooth decay in 5-year-olds continues to decline

Public Health England has published the oral health survey of five-year-olds 2017. The data shows that 23.3% of five-year-olds in England had decayed, missing or filled teeth in 2017, a decrease to 30.9% from 2008.

The report however identified that clear inequalities in oral health remain, with children in deprived areas more likely to be affected.

Other key facts include:

  • there is almost a 20-fold difference in severity between the lower-tier Local Authorities;
  • children from deprived backgrounds have higher levels of decay than those least deprived; prevalence of tooth decay among most deprived children is 33.7% and for the least deprived is 13.6%;
  • children in particular ethnic groups had markedly higher levels of decay prevalence; among children from Eastern Europe the prevalence was 49.4%, compared to 19.6% for Black/black British; and
  • while dental decay levels are reducing, and there are signs that inequalities are beginning to reduce, the inequalities gap remains unacceptably high.

Media monitoring

On Monday 14th May 2018, the following stories were published:

  • Government pledges £40 million brain cancer research fund in honour of Tessa Jowell, reports iNews. In wake of her death due to brain cancer, Ministers pledged to fulfil requests made by the former Labour politician, including a commitment to a national rollout of a key brain cancer diagnosis test. Also featured in the BBC and The Times.
  • The number of children diagnosed with type-2 diabetes rockets by 25% in just four years, reports The Mail.

On Tuesday 15th May 2018, the following stories were published:

  • Wealthier children are at greater risk of dying from asthma, research suggests. Older adults in less affluent areas are at greater risk of dying from asthma, yet wealthier children also have a higher mortality rate than poorer peers according to a new study that highlights the wide variations in asthma care. Featured in iNews, The Times and The Mail.
  • The Express features a warning from PHE after 440 cases of measles have been confirmed this year. The UK has been warned to watch out for measles symptoms after some European countries are in the midst of a large outbreak.

On Wednesday 16th May 2018, the following stories were published:

  • According to Diabetes UK, a postcode lottery has emerged in the UK which has left the Flash Glucose Monitoring system only available to two in five areas in England. The charity argues that every area should have access for free on prescription. Featured in iNews and The Guardian.
  • More than 1,000 GPs have been lost since ministers set out plans to hire 5,000 more, official figures show. The Times reports that numbers have dropped, despite a pledge in 2015 to recruit 5,000 more GPs by 2020.
  • Nearly a quarter of five-year olds starting primary school in England have tooth decay, figures reveal. The Mail reports that some 23.3% of five-year olds have dental decay, according to PHE data.

On Thursday 17th May 2018, the following stories were published:

  • Patients’ access to vital medicines is at risk unless the Government secures a post-Brexit deal for the pharmaceutical industry that ensures the closest possible regulatory alignment with the EU, MPs have said. The Business, Energy and Industrial Strategy Committee published a report which said failure to secure a deal that ensures the minimum possible friction at borders will damage the UK’s pharmaceutical sector. Featured in The Independent.
  • The Alzheimer’s Society has warned that needless hospital admissions for dementia patients have risen by more than 70% over the last five years. They estimated there were up to 54,000 potentially avoidable emergency admissions in England last year. Reported in The Telegraph, iNews, The Independent, The Express, The Sun and the BBC.
  • The Express reports that the growing number of patients in care homes is putting an added strain on already stretched NHS resources. In England last year there were 22,089 occasions where private nursing home patients were taken to A&E, a rise of 26% in two years.
  • Wealthier people are half as likely to get dementia because they have enough money for a stimulating cultural life, reports The Times.

On Friday 18th May 2018, the following stories were published:

  • The NHS has been cracking down on payments from overseas patients, reports The Telegraph. NHS watchdogs are targeting 50 trusts who between them have failed to recover £44m owing to them from patients who are not entitled to free care. Also featured in The Sun.
  • Half a million doctors worldwide are sharing their knowledge on social media network MedShr to find answers for their patients. The network was set up by a London cardiologist in 2014, and doctors can post details of cases on it for other medics to offer answers. Featured in The Times.
  • Growing resistance to antifungal drugs ‘a global issue’, reports the BBC. Scientists are warning that levels of resistance to treatments for fungal infections are growing, which could lead to more outbreaks of disease. Also featured in The Independent, iNews and The Mail.

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