Weekly political news round up – 29th May 2015

May 29, 2015 in News by Whitehouse

Around the sector

NHS Clinical Commissioners, an independent membership organisation of clinical commissioning groups, has published a guide on how CCGs can engage with the public on “challenging decisions” about healthcare transformation. The guide states that successful service redesign and the consultation process it involves must be well planned with proper timeframes, and that the process of change should be clinically led with a strong evidence base for change, drawing on knowledge from other CCGs and the involvement of Healthwatch. It also emphasises that messaging should be simple and efficient, and inclusive of the media and the public.

Nursing Times has published a review of continence care around the world, which found that a key element in improving care would be to ensure the use of specialist nurses at the first assessment. Assessing the UK, the author of the review said that although continence care is unlikely to be included in the Quality and Outcomes Framework for general practice in the near future, linking the achievement of continence-related quality outcomes to payment has the potential to dramatically improve how continence care is regarded among GPs in the UK.

Queen’s Speech 2015

The State Opening of Parliament took place on Wednesday, marking the start of the 2015/2016 parliamentary year.

During the ceremony, the Queen’s Speech was delivered to Parliament – outlining the Bills which will be brought before Parliament in the next parliamentary year. This was the first Queen’s Speech by a majority Conservative Government since 1996.

The theme of the Queen’s Speech was that of a “one nation approach” that would help working people, support aspiration, give new opportunities to the most disadvantaged and bring different parts of the country together. Also included in the Speech was a reiteration of the Government’s commitment to continue with “long-term economic plan” to provide economic stability through bringing public finances under control and reducing the deficit.

Although there were no bills outlined specifically relating to health, there was a statement within the Queen’s Speech that the Government will “secure the future” of the NHS by implementing the Five Year Forward View, increasing the health budget by £8 billion a year by 2020, integrating health and social care, and ensuring that the NHS works on a 7 day basis, as well as through improving access to general practitioners and mental healthcare. There was no specific mention of child health in the Queen’s Speech.

As expected, the Queen’s Speech included plans to legislate on an in/out referendum on the EU by the end of 2017, as well as further devolution plans for Scotland, Wales, Northern Ireland and cities with elected mayors. There was also a commitment to ensure that decisions affecting England, or England and Wales, can only be taken with the consent of the majority of MPs representing constituencies in England, or in England and Wales. As such, this would bar Scottish MPs from voting on matters that only affect England and Wales.

Weekly political news round up – 22nd May 2015

May 22, 2015 in News by Whitehouse

Around the sector

Public Health Minister Jane Ellison has been given responsibility for children’s health at the Department of Health, taking over the portfolio from former Health Minister Dan Poulter, who left the department to dedicate more time to his medical career. Ellison is also responsible for long term conditions, school nursing and health visiting.

The SNP have announced that Philippa Whitford has been appointed as their Health spokesperson, and Carol Monaghan as their Education and Public Services spokesperson.

Party leaders have agreed on the distribution of Select Committee Chairs, with the Conservatives with the chairmanship of 14 committees, Labour with 10 committees, and the SNP with two. As expected, the Conservatives will chair both the Health Select Committee and the Education Select Committee.

The Times has reported that leaders of NHS hospitals, mental health and community care trusts have told Prime Minister David Cameron to “put his money where his mouth is” in response to his promise of an extra £8 billion to help address the funding gap, arguing that that amount alone will not be enough to stop rationing and rising waiting lists. In addition to the £8 billion, they argued that they wanted a guaranteed spending escalator each year of this parliament, with more money for social care and £2 billion to cover one-off changes.

GP Online has reported that a survey of 164 GPs on their experience of the CQC found that 38% of them believed that the organisation required improvement. However, 32% of those responding that their experience of the CQC had been a positive one, with a further 6% stating that the CQC had been outstanding.

Chancellor George Osborne has announced that there will be a Summer Budget on Wednesday 8th July 2015. Whitehouse will produce a summary of the main issues surrounding health care for the PCF on the day.

NICE announce surveillance review for clinical guideline 54: UTI in children

NICE have announced that they are conducting the eight year surveillance review of clinical guideline 54: UTI in children.

By way of background, NICE undertakes two different types of review every two years, with one type being more substantial than the other.

The first surveillance process is at the 2-year, 6-year and 10-year time points following initial publication of the document. These reviews, which do not call for the views of the original Guideline Development Group members, are less-resource intensive and are intended to be done relatively quickly.

More substantial reviews are done at the 4-year and 8-year dates after publication. These reviews consider whether the guideline is still appropriate, or whether it needs to be updated in light of new evidence. During this process, the original guideline development group members (who helped produce the guideline), will be surveyed to get their opinions on the existing guideline, recent developments in the topic area and their knowledge of any new important evidence since the original publication. The NICE Information Services team are tasked to conduct a literature search across a range of databases.

Reviews have five possible outcomes, which are:

  • Substantial update – the update will follow the standard guideline development process, much like a new clinical guideline would. The update would be consulted on.
  • Rapid update – discrete changes will be made following an assessment by the Updates Standing Committee. Draft recommendations would be consulted on.
  • No update – no changes will be made. A consultation will be held if this happens.
  • Transfer to static list – clinical guidelines that have undergone a review and been recommended for ‘no update’ will be considered for the static list. Guidelines on the static list will only be assessed every five years. A consultation will be held on this decision.
  • Withdraw the guideline – the guideline will no longer apply. Stakeholders will be consulted.

Health Secretary Jeremy Hunt outlines priorities for the next five years

In his first speech since being reappointed Health Secretary, Jeremy Hunt provided a very brief outline of his priorities for the next five years – focusing on existing priorities like health care funding, and greater attention on other areas like obesity and diabetes.

Discussing taking forward the Five Year Forward View, he reiterated the commitment to find at least £8 billion to help address the funding gap, emphasising that there were “huge pressures” to tackle the deficit and that some of the £8 billion would come from cuts to other departments. On the £22 billion of productivity and efficiency savings, Hunt said that there needed to be a “much more detailed discussion” about this element of the Forward View and that this discussion had to happen quickly. He added that there was a necessity to eliminate waste, improve efficiency but also improve quality and access at the same time.

Hunt also said that there needed to be a new focus on addressing issues around general practice, notably improving the number of GPs. He added that there needed to be a change in NHS culture, criticising the focus on targets rather than outcomes. Finally, he said that there needed to be a “big public health agenda” around obesity and diabetes.

 

Weekly political news round up – 15th May 2015

May 15, 2015 in News by Whitehouse

Around the sector

Two Liberal Democrat MPs have announced their intention to run for their party’s leadership. Tim Farron, former President of the Liberal Democrats, announced his candidacy on Thursday, with former Care and Support Minister Norman Lamb announcing his candidacy on Tuesday. Both candidates have said that they will seek to rebuild and restore trust in their party, which suffered its worst electoral result in 45 years.

The Financial Times has reported that Chancellor George Osborne may be delivering a second Budget “relatively soon”, rather than waiting until next March, according to his colleagues. The new Budget would be the first of the majority Conservative Government, and the first devised free from Liberal Democrat influence. Although the broad economic strategy of fiscal austerity is expected to remain unchanged the Chancellor will be challenged to deliver promises made during the election campaign, including finding the additional £8 billion promised for the NHS by 2020, as identified by NHS England chief executive Simon Stevens.

Government and Shadow Government positions announced

Prime Minister David Cameron has announced his Cabinet, with the broad theme being of continuity rather than change.

The most important announcement for the PCF is that both Health Secretary Jeremy Hunt and Education Secretary Nicky Morgan have retained their positions.

The new Cabinet contains very few changes to the last, with Conservatives filling in the positions vacated by the Liberal Democrats, notably Sajid Javid replacing Vince Cable as Business Secretary and Amber Rudd replacing Ed Davey as Energy Secretary. Of the previous Cabinet, former Communities Secretary Eric Pickles is now the only Conservative now absent.

Ministerial announcements were also made this week. Children’s Health Minister Dr Dan Poulter has left the Department of Health to focus on his medical career, with Ben Gummer being appointed as Health Minister, with precise responsibilities still due to be announced. Health Minister Earl Howe has moved to the Ministry of Defence, and is to be replaced by CQC Chair David Prior, pending Prior’s appointment as a peer. Children and Families Minister Ed Timpson, who oversaw the passage of the Children and Families Act 2014, has retained his position.

The vast majority of junior ministerial level appointments have been made, with a handful pending confirmation.

Opposition

Acting Labour leader Harriet Harman, who has temporarily replaced Ed Miliband after he stepped down on Friday, has also appointed her Shadow Cabinet.

Andy Burnham has retained his role as Shadow Health Secretary, with Tristram Hunt retaining his role as Shadow Education Secretary.

Other major announcements include Chris Leslie replacing Ed Balls as Shadow Chancellor, and Hilary Benn replacing Douglas Alexander as Shadow Foreign Secretary – with the previous occupiers both losing their seats last week. Junior shadow ministers have not yet been confirmed.

As with the Government, the Opposition has made few changes overall.

Candidates announce intention to run for Labour leadership

Four Labour MPs have announced that they will be running for leadership of the Labour Party, following Ed Miliband’s decision to step down the day after the election. Each candidate must gain the support of 35 Labour MPs to appear on the ballot, with the winner due to be announced at a special conference on 12th September 2015.

Below is a summary of the candidates so far:

Shadow Home Secretary Yvette Cooper

Cooper was elected as an MP in 1997 and is currently Shadow Home Secretary, having previously been Shadow Pensions Secretary, Shadow Foreign Secretary, and Shadow Women’s Minister. She also has experience in government, having been Pensions Secretary, Chief Secretary to the Treasury and Housing Minister under Gordon Brown.

She has said that she wants to “make life better for Britain’s families”, arguing that Labour had to move “beyond the old labels of left and right” and focus “four-square on the future”.

Cooper is considered a centrist choice, and is considered to have a chance of winning but is not considered by bookies to be the favourite.

Shadow Health Secretary Andy Burnham

Burnham was elected as an MP in 2001 and was appointed Shadow Health Secretary almost four years ago, having previously been Shadow Education Secretary. Burnham was Health Secretary for little under a year as part of Gordon Brown’s government, having also been Culture Secretary and Chief Secretary to the Treasury.

He said that Labour had “lost its emotional connection with millions of people” and that the challenge for the party was “not to go left or right, to focus on one part of the country above another, but to rediscover the beating heart of Labour”.

Burnham is considered to be towards the left of the party and has the backing of the unions, with bookies giving him a reasonable chance of being appointed leader.

Shadow Business Secretary Chuka Umunna

Umunna was elected as an MP in 2010, and has been Shadow Business Secretary for almost four years.

He said that during the election, Labour “spoke to [their] core voters, but not to aspirational, middle-class ones”, adding that they “talked about the bottom and top of society, about the minimum wage and zero-hour contracts, about mansions and non-doms”, but that they had “too little to say to the majority of people in the middle”.

Umunna, who has been touted as the “British Obama” and is considered a front-runner by bookies in the contest, is situated to the right of Ed Miliband and is seen by Blairites as the man to bring back all the Tory voters who didn’t trust Labour.

Shadow Care and Support Minister Liz Kendall

Kendall was elected as an MP in 2010, and has been Shadow Care and Support Minister for almost four years.

She said that Labour did not set out a positive enough alternative to the Conservatives and did not obtain the trust of people on the economy.

Kendall said that returning to New Labour was not the answer, instead suggesting that something new should be created for 2020. She is considered an outsider by bookies in the leadership race.

Shadow International Development Secretary Mary Creagh

Creagh was elected as an MP in 2005, and has been Shadow International Development Secretary for 6 months, having previously been Shadow Transport Secretary and Shadow Environment Secretary.

Announcing her intention to run in an article in the Daily Mail, she said that Labour’s election campaign “didn’t understand” the aspiration of people to “earn money and provide a better life for their family”, adding that although Labour were trusted to look after schools and hospitals, they were not trusted with the economy.

Weekly political news round up – 8th May 2015

May 8, 2015 in News by Whitehouse

Around the sector

The Royal College of General Practitioners has published analysis which found that if current trends of GP recruitment continue, patients will have to wait until 2045 for the 8000 extra GPs promised by Labour and UKIP in their manifestos, and until 2034 for the extra 5000 proposed by the Conservatives. The RCGP subsequently called on the next government to introduce an urgent package of measures to recruit new GPs, retain existing ones and encourage those who have taken a career break to return to the profession and frontline patient care.

The Daily Mirror has published the results of a survey of nurses which found that 79% of them said that patients received a better standard of care prior to 2010. The poll also revealed that patients are routinely let down because over-stretched staff do not have time to care for them properly, and that staff feel undervalued and exhausted, with morale the worst in 32 years.

The Telegraph has reported on a study by the Economic Intelligence Unit, which showed that Britain ranked 28th in a league table of 30 countries belonging to the Organisation for Economic Co-operation and Development (OECD), which represents some of the most economically developed countries in the world. The statistics showed that the UK had 2.8 doctors per 10,000 people in 2012, compared with 3.2 in other wealthy OECD countries. For nurses, the figure was 8.2 per 10,000 in the UK compared to an average of 8.9 amongst the 30 examined.

Conservatives win 2015 General Election

The 2015 General Election has resulted in a majority Conservative government, with the Conservatives projected to win 331 seats – a majority of 5 seats and an increase of 25 from their 2010 result.

The results so far have shown that the Conservatives have performed above expectations, with Labour performing significantly below expectations. Having previously been neck-and-neck in the opinion polls with the Conservatives, Labour are projected to gain 232 seats – an overall loss of 26 seats from 2010. The Liberal Democrats also faced severe losses, being defeated in 48 out of 56 of their seats.

One of the most significant developments was in Scotland, with the rise of the SNP and the complete collapse of the Labour and Liberal Democrat vote. The SNP have won 56 of the 59 of the seats available, making them the most dominant political party in Scottish history.

UKIP have increased their share of the vote – from 3% in 2010 to 13% in 2015, but this has translated into just one seat.  Plaid Cymru gained three seats, with the Green Party retaining their single seat.

Overview for the PCF

With the Conservatives set to form the next government, we are likely to see broad continuation of the health policies that we saw in the previous government.

More specifically, it means that the following pledges outlined in the Conservative manifesto are likely to be taken forward:

  • The commitment to provide an extra £8 billion for the NHS in England.
  • Expansion of GP access for all people to 7 days a week, from 8am to 8pm, by 2020.
  • Encouragement of large-scale trials of innovative technologies and health services.
  • Access to full information about the safety records of their hospital and other NHS or independent providers.
  • Increased use of cost-effective new medicines and technologies.
  • The implementation of the findings of the Accelerated Access review into innovative medicines and medical technologies.

There are likely to be some changes to the Government’s health team, now that the Conservatives have secured a majority. There may be a full reshuffle, and Norman Lamb will not continue as Care and Support Minister given the results for the Liberal Democrats, nor will David Laws continue as Schools Minister due to the loss of his seat. Prime Minister David Cameron will be announcing his Cabinet within the next couple of days, with ministers to be appointed shortly thereafter.

Labour, who will continue in opposition, will likely undergo some restructuring, with Labour Leader Ed Miliband stepping down and Shadow Chancellor Ed Balls losing his seat. Former coalition partners the Liberal Democrats will also require a period of reflection, with Nick Clegg also resigning, and various senior officials such as Business Secretary Vince Cable and Energy Secretary Ed Davey losing their seats.

Numerous respondents to the PCF’s manifesto mail out were elected as MPs. The following newly elected MP stated that they would support the manifesto:

  • Conservative MP Maria Caulfield
  • Labour MP Rob Marris
  • Labour MP Dr Peter Kyle
  • Labour MP Justin Madders
  • SNP MP Steven Paterson

The following newly elected MPs thanked us for sending the manifesto:

  • Conservative MP Michael Tomlinson
  • Conservative MP Kelly Tolhurst
  • Labour MP Peter Dowd
  • Labour MP Judith Cummins
  • Labour MP Liz Saville-Roberts
  • SNP MP Neil Gray

Existing PCF supporters were also re-elected. As well as the re-election of Conservative MP Paul Maynard, the following MPs who attended the drop-in event in October were re-elected:

  • Conservative MP Oliver Heald
  • Conservative MP David Amess
  • Conservative MP Paul Maynard
  • Conservative MP Henry Smith
  • Labour MP Grahame M. Morris
  • SDLP MP Mark Durkan

Unfortunately, both Liberal Democrat MPs Paul Burstow and Duncan Hames were not re-elected.

The new parliament will be sworn in during the week commencing Monday 18th May, with the Queen’s Speech – which marks the formal start of the parliamentary year and sets out the government’s agenda for the coming session – due to take place on Wednesday 27th May. Select Committee chairs are due to be elected in early June, with committee members to be confirmed in early to mid-July.

Weekly political news round up – 1st May 2015

May 1, 2015 in News by Whitehouse

Around the sector

The Guardian has reported that analysis by health think-tank the King’s Fund has found that it is “quite possible” that NHS England will miss the £22 billion target of efficiency savings by “quite a long way”, and will require much more than the £8 billion in additional funding a year that it has requested to alleviate its funding shortfall. The research found that 69 of the 93 finance heads at NHS trusts believed there was either a high or very high risk of the NHS in England failing to achieve the £22 billion target, with 27 of 40 finance directors at GP-led NHS CCGs believing the same.

The Royal College of Nursing has published the findings of a survey of 14,000 nursing staff, which found that 18.3% were unable to complete training last year. Of these, 44.4% said that they had not completed training because there were too few staff to cover their work. Of those who had undertaken the training, 48% said no cover was provided while they were absent from normal duties. A further 10% said that they had to use annual leave to complete compulsory training in their own time.

The Royal College of Nursing has also published the results of a poll by Ipsos MORI which showed that 88% of British adults believed that there should be more nurses in hospitals to deliver safe care. A further 83% of respondents felt that nurses should speak up in the general election campaign about what they believe matters.

Royal College of Paediatrics and Child Health launches new standards to improve unscheduled care for children

The Royal College of Paediatrics and Child Health (RCPCH), along with the Royal College of General Practitioners (RCGP) and the Royal College of Nursing (RCN), have published a report containing a new set of standards designed to improve unscheduled care for children.

The report, Facing the Future: Together for Child Health, argues that in order to deal with increasing numbers of admissions to hospitals, and to improve child health outcomes, not only do unscheduled care services need more investment but there also needs to be a shake-up of how services are designed, with more children being cared for outside the hospital, in the community and closer to their home.

To address these issues, the three organisations have developed 11 standards which are covered by three overarching principles. These standards are not mandatory, but are seen as something to strive towards. Below is a summary of the standards:

Supporting primary care to care for the child safely in the community, preventing unnecessary attendances

  1. GPs assessing or treating children with unscheduled care needs should have access to immediate telephone advice from a consultant paediatrician.
  2. Each acute general children’s service should provide a consultant paediatrician-led rapid access service so that any child referred for this service can be seen within 24 hours of the referral being made.
  3. There should be a link consultant paediatrician for each local GP practice or group of GP practices.
  4. Each acute general children’s service should provide, as a minimum, six-monthly education and knowledge exchange sessions with GPs and other healthcare professionals who work with children with unscheduled care needs.
  5. Each acute general children’s service should be supported by a community children’s nursing service which operates 24 hours a day, seven days a week, for advice and support, with visits as required depending on the needs of the children using the service.

Reducing the length of stay and enabling children to go home as quickly as possible, without risk of unnecessary readmissions

  1. There should be a link community children’s nurse for each local GP practice or group of GP practices.
  2. When a child presents with unscheduled care needs the discharge summary should be sent electronically to their GP and other relevant healthcare professionals within 24 hours and the information is given to the child and their parents and carers.
  3. Children presenting with unscheduled care needs and their parents and carers should be provided, at the time of their discharge, with both verbal and written safety netting information, in a form that is accessible and that they understand.

Improving patient experience and streamlining the patient journey

  1. Healthcare professionals assessing or treating children with unscheduled care needs in any setting should have access to the child’s shared electronic healthcare record.
  2. Acute general children’s services should work together with local primary care and community services to develop care pathways for common acute conditions.
  3. Documented, regular meetings should be attended by senior healthcare professionals from hospital, community and primary care services and representatives of children and their parents and carers to monitor, review and improve the effectiveness of local unscheduled care services.