Weekly political news round up – 21st October 2016

October 24, 2016 in News by Whitehouse

Overview

The Department of Health has announced a new nursing-specific post that will focus on nursing and allied health professional policy issues, including parliamentary business. Deborah Glover, member of the Royal College of Nursing, triggered a Government response when she created a petition to oppose the Government’s decision to scrap the nursing directorate in the Department of Health, which attracted more than 10,000 signatories. Commenting on the Government’s decision, Ms Glover said: “It’s positive that a new nursing post will form part of the new structure”. She also said she looks forward to working with the Department of Health to ensure nursing is incorporated into health policy that will impact on patient care

This week in Parliament the Prime Minister reportedly told the chief executive of NHS England, Simon Stevens, that the NHS will not receive additional funding in the Autumn Statement. The reforms to community pharmacy have been finalised by Parliamentary Under-Secretary of State for Community Health and Care, David Mowat; and Mrs May scrapped the Cabinet’s health and social care taskforce. NHS Wales was also promised a 2.5% increase in funding from the Welsh Assembly’s 2017/18 budget.

Outside of Parliament, Cumbrian school nurses and health visitor services face being terminated to enable Cumbria County Council to cut children’s public health spending by more than £700,000. The Royal College of Nursing has warned the Government of the potential for a “perfect storm” in the worsening of the current nursing recruitment and retention crisis; and the Secretary of State for Health Jeremy Hunt revealed that he plans to prioritise children’s mental health services and reduce NHS dependency on agency staff over the coming years.

Parliamentary and political developments

Government publishes reforms to community pharmacy funding

David Mowat, Parliamentary Under-Secretary of State for Community Health and Care, announced  details of the changes to community pharmacy funding to the House of Commons this week. Mr Mowat stated

that while the Government appreciates the role of the community pharmacy sector in relieving pressure on other primary care facilities such as urgent care, the current system does not promote consistency or quality. Currently 40% of pharmacies are in geographical clusters of three or more, and two out of five pharmacies are within a ten-minute walk from each other.

For 2016/17, community pharmacies will receive £2.687 billion in funding – representing a 4% reduction – and in 2017/18 they will receive £2.592 billion, a further 3.4% reduction. From 1st December 2016, payment structures will be simplified and a payment for quality of services will be introduced, meaning pharmacies will not only receive payments for the volume of prescriptions they dispense but also the level of care provided.

NHS England has said that it will be supporting the transformation of community pharmacies through a £42 million Pharmacy Integration Fund. The money will go towards new clinical pharmacy services, working practices and digital platforms that are intended to meet public expectations and demand. In the statement made by Mr Mowat, he could not confirm how many, or if any, pharmacies will close due to the funding reductions. His department has said the reforms will “modernise the community pharmacy sector” and will not adversely affect patient access to community pharmacies. Labour’s newly-appointed Shadow Secretary of State for Health, Jonathan Ashworth, accused the Government of failing to “engage constructively” with the Pharmaceutical Society Negotiating Committee over the cuts, and labelled the plans a “false-economy”. Industry representatives also believe the cuts will have a detrimental impact on community pharmacy services and access. Rob Darracott, Chief Executive of the trade association Pharmacy Voice, said that the reforms are “incoherent, self-defeating and wholly unacceptable”.

Draft Wales Budget 2017-2018 promises 2.5% increase in NHS funding

The Welsh Government has proposed £276 million for NHS core services in the draft Welsh Budget for 2017-2018, representing a 2.5% increase in real terms in health funding. From 2017-2018, £240 million will be given to the Welsh NHS to meet the growth in demand and costs of services, and £60 million will be invested in the Intermediate Care Fund, which aims to help people be independent in the community and prevent unnecessary hospital admissions. Over the next four years, the money committed to infrastructure will also involve an investment of £1 billion to transform and maintain the NHS estate.

Anita Charlesworth, Director of Research and Economics at the Health Foundation, has welcomed the Welsh Government’s recognition of the pressures the health service faces. However, she also highlighted that the money must “support the transformative change and improved efficiency” needed to meet the long-term challenges the Welsh NHS faces. Welsh Assembly Committees will now hold evidence sessions on specific issues within the draft budget, which will contribute to the Finance Committee’s report on the Welsh Budget 2017-18 to be presented to the Assembly. The Assembly will use the findings of the report when considering the motion to approve the budget.

Health Select Committee hears evidence from Health Secretary and NHS England’s chief executive

The Prime Minister has reportedly told the chief executive of NHS England, Simon Stevens, that the NHS will not be eligible for any additional funding in the Autumn Statement on 23rd November, despite continued calls from the health sector. During her first meeting with Mr Stevens since becoming Prime Minister, Mrs May is reported to have urged him to instead consolidate the £22 billion efficiency drive already planned for the NHS over the coming years, using her own experience of “painful cuts” to the Home Office’s budget while she was Home Secretary to substantiate her decision.

Mr Stevens then publicly questioned the Government’s claim that the NHS will receive an additional £10 billion by 2020 in a session with the Health Select Committee. He told the Committee that for 2017/18, 2018/19 and 2019/20 the NHS did not receive the degree of funding requested, and so “as a result we have a bigger hill to climb.” The Health Secretary also gave evidence to the Committee during the session, and suggested that any additional funding announced in the Autumn Statement would be directed to social care rather than the NHS, given the growing pressures in the sector and their knock-on impact for the health service.

Prime Minister scraps Cabinet’s health and social care taskforce

The Government has published an updated list of cabinet committees and implementation taskforces, which shows that the Prime Minister has chosen not to continue with a cabinet committee for health and social care, as established by David Cameron. The former Health Minister, Dr Dan Poulter MP, said it was “regrettable” that the Committee had been scrapped, and that “it would be deeply concerning if this in any way indicated an intention to deprioritise government efforts to improve care for the frail, elderly and other vulnerable people who are in need of social care.”

One of the committees set up instead, chaired by the Education Secretary Justine Greening, will focus on childcare; with the remit to “drive delivery of a coherent and effective government-wide childcare offer to support parents to work.” The Prime Minister’s decision to chair four of the five cabinet committees herself – compared with two which were chaired by David Cameron – has been interpreted as an assertion of her strength. Jill Rutter, of the Institute for Government, said that “It is clear that [May] intends to assert herself” from this reduced degree of delegation.

Health Secretary gives interview on priorities to Health Service Journal

Jeremy Hunt has said in an interview with Health Service Journal that the number of nurses employed by the NHS should rise as NHS providers reduce dependency on expensive agency and locum staff. According to the Health Secretary, there has been an increase of around 10,000 whole-time equivalent nurses in the English NHS since 2012. He intends to prioritise children’s mental health in the NHS, stating it is the “biggest single area of weakness in NHS provision”. The integration of children and adolescents’ mental health services (CAMHS) into schools was proposed to allow the NHS to “make a lot of headway” in treating children’s mental health conditions.

In the interview, Mr Hunt also stated that he wants to remain as Health Secretary for another two or three years, which would make him the longest-serving Health Secretary ever. He also acknowledged in a speech to the GP Best Practice conference this week that underinvestment in GP training throughout his tenure as Health Secretary has now “caught up” with him, stating he could have taken a longer-term view to planning and funding the health service.

Clinical developments

Cumbrian school nurses and health visitor services face being cut

School nursing services in Cumbria face being terminated, in a bid by the local authority to cut children’s public health spending by more than £700,000. Cumbria County Council’s decision has been called a “disaster” by a former public health director, and has said it implies that children in the county are not considered a priority.

Currently, there are eleven full-time equivalent school nurses working in Cumbria. A report by Colin Cox, Cumbria Council’s assistant director for health, care and community services, revealed that the service is unsustainable because it is under-resourced. Instead, the report advocates six “health coordinators” to replace the school nurse service and for the number of health visitors to be reduced from 87.5 full-time equivalents to 71. Both of the services are provided by Cumbria Partnership NHS Foundation Trust, who has said that redundancies cannot be ruled out should the proposals go ahead.

Professor John Ashton, former director of public health in Cumbria, has called for the plans to be rejected. He said “School nurses are in the front line. How can they give a better service by getting rid of them?” Professor Ashton also listed obesity, fitness and mental health as the health challenges children are currently facing that could be compromised by reductions to school nursing services.

Royal College of Nursing warns of ‘perfect storm’ for worsening nursing shortage

The Royal College of Nursing (RCN) has warned that the current nurse shortage in the UK is likely to get worse if the Government does not take immediate action to tackle recruitment and retention problems. Describing the conditions the workforce is up against as a “perfect storm”, the RCN said that rising demand; an ageing workforce nearing retirement; insufficient numbers of trainees; and potential threats to international recruitment stemming from Brexit, are all contributing to the staffing crisis.

Official data from NHS Digital shows that overall the NHS workforce increased by 1.7% in 2015, but the number of learning disability nurses reduced by 23% and the community nursing workforce dropped by 11%. Additionally, the decision to remove bursaries for nursing students puts the number of trainee nurses at risk and could lead to an uneven distribution of trainees across regions and specialities. Janet Davies, RCN chief executive and general secretary, said that “the government has largely ignored the crisis facing the nursing workforce” and called for a “coordinated, long-term strategy to train more nurses”.

The Secretary of State for Health Jeremy Hunt announced at the 2016 Conservative Party Conference that his department is going to increase the number of medical student places, but laid out no plans on how to increase the nursing workforce. The RCN’s report confirms that the nursing profession faces significant obstacles over the coming years, particularly for speciality services such as mental health, community and disability nursing.

Weekly political news round up – 14th October 2016

October 24, 2016 in News by Whitehouse

Overview

This week, Jeremy Corbyn has conducted a Shadow Cabinet reshuffle following his re-election as Labour leader, completing his shadow health and education teams. A question about urology and prostate nurses has been asked by the Conservative MP Michael Fabricant to the Prime Minister during PMQs, and a report by the Health Foundation, a health think tank, has warned there could be a £700 million shortfall in the NHS in Wales by 2020.

Labour leader appoints Shadow Cabinet ministers

Jeremy Corbyn has conducted his third Shadow Cabinet reshuffle since becoming leader of the Labour Party in September 2015, following his re-election to the post in September. Many MPs who had previously resigned from the frontbenches in protest at his leadership have now returned to shadow ministerial positions, with many citing the wish to unite behind his leadership.

Of relevance to the PCF, Jonathan Ashworth MP has been appointed as Shadow Secretary of State for Health following the promotion of Diane Abbott to Shadow Home Secretary. Sharon Hodgson MP has been appointed as Shadow Minister for Public Health, having previously served as a Shadow Education Minister. We would expect her to be the most relevant health minister for the PCF, given she will be mirroring Nicola Blackwood MP, who has responsibility within government for children’s health and school nursing. Julie Cooper MP has been appointed as Shadow Minister for Community Health, while Barbara Keeley MP returns to her previous role as Shadow Minister for Mental Health and Social Care, which has been expanded slightly to include a mental health remit.

Angela Rayner MP remains Shadow Secretary of State for Education, with Emma Lewell-Buck MP appointed to serve under her as Shadow Minister for Children and Families. Ms Lewell-Buck will be shadowing Edward Timpson MP within the Government, and replaces Sharon Hodgson in the role. Tulip Siddiq MP – who has previously called for the “special needs price-tag”, imposing additional costs on services and goods needed by those with SEND, to be mitigated – has been appointed as Shadow Minister for Early Years; and Mike Kane MP has been selected as Shadow Minister for Schools.

Question about urology and prostate nurses asked during PMQs

Michael Fabricant MP (Con, Lichfield) has asked the Prime Minister a question on the looming shortage of specialist prostate and urology nurses during this week’s Prime Minister’s Questions (PMQs). Mr Fabricant described his own recent experience of having a prostatectomy due to being at risk of prostate cancer, and used it to highlight the expected shortage of specialist prostate and urology nurses expected to arise over the next decade due to the retirement of existing specialists. He concluded his statement by asking “what the Government can do to avert a shortage of these much needed specialist nurses?”

The Prime Minister’s response focused on efforts to increase awareness of cancer – given that Mr Fabricant received treatment to avoid prostate cancer – but did say that the Government “will look at the training of nurses – 50,000 nurses are in training – and continue to make sure that the specialisms are available to do the work that is necessary in the health service.”

Health Foundation report warns of £700m NHS Wales shortfall

A report by an influential think tank, the Health Foundation, has warned of the need for the NHS in Wales to find £700 million in efficiency savings if it is to avoid a funding shortfall of the same amount by 2019/20. Although this would equate to 10% of the health service’s current budget, it is thought that almost £300 million will be saved by the 1% cap on public sector pay increases imposed by the UK Government.

The analysis is based on the assumption that Welsh spending on the NHS between now and 2020 will increase by 0.7% annually – as expected in England – but spending has only grown by 0.1% in Wales in recent years. The authors call for increases of 2.2% above inflation each year between 2019/20 and 2030/31 to sustain services, to meet the growing demands caused by long-term health conditions and inadequate social care.

Weekly political news round up – 7th October 2016

October 24, 2016 in News by Whitehouse

Overview

This week, Secretary of State of Health Jeremy Hunt MP delivered his speech to the Conservative Party Conference, where he outlined his plans to expand the medical staff workforce and increase the mandatory amount of time a trainee doctor must work in the NHS after completing training to four years. The latter policy is expected to be funded through existing budgets, at a predicted cost of £100 million. The Royal College of Nursing welcomed the Health Secretary’s commitment to the medical staff workforce, but highlighted that he must address problems within the existing workforce such as staff retention. In a speech to the Queen’s Institute of Nursing, Senior NHS Improvement Nurse Dr Ruth May also highlighted the looming nursing shortage and her plans on how to increase the nursing workforce.

Elsewhere, ITV’s This Morning’s Second Opinion discussed the problems faced by a caller after she developed incontinence problems. Finally, Prime Minister Theresa May delivered her closing speech to the Conservative Party Conference on Wednesday, giving praise to Jeremy Hunt for his commitment to the NHS and citing her party’s £10 billion investment in the health service.

Health Secretary Jeremy Hunt delivers speech at the Conservative Party Conference

Jeremy Hunt delivered his speech to the Conservative Party Conference yesterday, addressing his key priorities of cancer treatment, mental health and improving communication with patients and their families. He also outlined his plan to boost the number of medical students in the UK. Mr Hunt stated that from 2018, the cap on the number of medical school places will be increased by 25% to train 1,500 more doctors per year. The Health Secretary urged that doing so will enable the NHS to become ‘self-sufficient’ and stop it from having to rely on doctors from overseas.

He also announced that trainee doctors will be expected to work for four years in the NHS after completing their training, and suggested that this will increase the number of doctors available to the NHS, reduce gaps in working rotas and cut the amount of money spent on agency staffing. Significantly, there is not expected to be additional funding allocated to the policy – which will cost approximately £100 million – indicating it will be financed through existing budgets. However, the BMA has warned that this does not tackle the root causes of the crisis and the extra training places will take a decade to deliver the number of doctors needed.

Another key point of the Health Secretary’s speech were his comments to the British Medical Association (BMA). While Mr Hunt stated that he was ‘pleased’ that the BMA cancelled planned junior doctor strikes, he further urged the BMA to stop all strikes and work with the Government to deliver a ‘7 Day NHS’.

Nurse staffing and retention must be prioritised by Health Secretary Jeremy Hunt

The Royal College of Nursing (RCN) has responded to the Health Secretary’s party conference speech by welcoming his acknowledgement of the workforce crisis facing the NHS; but pointed out that Mr Hunt must address the pressures facing existing healthcare staff. The RCN said that the NHS is currently struggling to retain the staff it trains, and more needs to be done to help staff deliver better care to patients. Associate Director of Policy, Lara Carmona, highlighted that “many nurses are working for agencies because they can no longer afford to work for the NHS after a 14% real-terms pay cut in recent years”.

Dr Ruth May, Senior Nurse for the new regulator NHS Improvement, also spoke at a Queen’s Nursing Institute conference on her workforce objectives, which she described as “staffing, staffing and staffing”. Dr May highlighted that the biggest staffing challenge is faced by community nurses, and said she is concerned about new graduates going into communities and the need for them to be supported by “very experienced community staff”, which is currently under threat. In her role at NHS Improvement, she is intending to support a “talent pool” of deputy nursing directors that will enable them to progress to become nursing directors, especially from community settings.

This Morning TV breakfast show discusses woman’s incontinence experience

The Express  has reported this week about a  woman calling ITV’s This Morning’s Second Opinion daily breakfast TV show, to discuss her incontinence problems with the on-show doctor Dr Ranj. The caller, named Lorraine, described how she had suffered from incontinence and had received Botox injections in her bladder to address the issue. However, she now suffers from not being able to empty her bladder properly and uses a catheter. Dr Ranj advised that the Botox treatment will wear off after six to nine months and the side effects will subside after this.

Urge, stress and mixed continence are discussed in the article and it mentions that urinary incontinence can affect women at any age, but the most common causes are pregnancy, childbirth, ageing and being overweight. When questioned by the Express.co.uk, GP and women’s health expert Naomi Potter advised people experiencing incontinence to try a range of solutions, from weight management, pelvic floor exercises and surgery.

Theresa May’s closing speech to the Conservative Party Conference

Prime Minister May closed the Conservative Party’s 2016 Conference with a speech setting out her commitment to create “a country that works for everyone”, and what “Britain after Brexit” should look like. Mrs May called on her colleagues to recognise the new centre ground of British politics now felt by the working class, who she said carried out a “quiet revolution” when they predominantly voted for Brexit in June.

Mrs May stated that the Conservative Party is united in its support for the NHS as a provider of free-at-the-point-of-use health care, and denied that her party wishes to privatise the NHS. She instead attacked the Labour Party by highlighting the pace that Tony Blair’s government expanded the use of the private sector in the NHS.

The Secretary of State for Health, Jeremy Hunt, was praised by the Prime Minister for being “one of the most passionate advocates for patients” and healthcare professionals. While she cited her party investing an extra £10 billion in the NHS, she did not address any of the policy commitments made in Hunt’s own speech to the Conference, nor the growing recruitment crisis the sector faces.

Turning her own phrase on its head, the Prime Minister called Labour the new “nasty party” due to its current fractious state, and claimed the Conservative Party will “build bridges” to represent the needs of the many. May offered a balanced argument of supporting free trade and the market, while simultaneously being a government prepared to intervene when markets are “dysfunctional”.

Weekly political news round up – 30th September 2016

October 24, 2016 in News by Whitehouse

Overview

This week, a report on school nurses has been published by the National Children’s Bureau, which investigated school nurse job satisfaction and workforce morale and concluded that school nurses felt confident in dealing with a number of long-term health conditions. The Welsh Government has launched its Healthy Child Wales Programme that will establish a universal health programme for all families with children from the ages of 0-7, and comes into force 1 October 2016; while Anglesey Council has revised its plans to require parents to prove their child’s age before agreeing to collect soiled nappies, which was criticised for neglecting the needs of older children wearing nappies. World champion athlete Denise Lewis has called on people to talk about their incontinence issues during the UK’s First Pelvic Floor Week, and the Labour Party Conference was held in Liverpool, with speeches from Jeremy Corbyn, Shadow Health Secretary Diane Abbott and Shadow Education Secretary Angela Rayner.

Elsewhere, the Health Minister Philip Dunne has ruled out giving the NHS a “Brexit bonus” after Lord Lansley’s suggestion that the NHS should be given £5 billion after leaving the EU. Mr Dunne clarified that because all Whitehall Departments will be bidding for as much funding as possible after the UK officially leaves the EU, the Health Department should not be “counting any chickens at this stage”. Additionally in the Nursing Times a blog has been posted arguing that continence services should be split into two services: one for those who experience “traditional” continence issues later on in life, and one for the “less traditional user group” of people with lifelong conditions. This is to enable continence services to be truly sensitive to the needs and issues of incontinence sufferers.

Last, the Daily Mail has reported that middle-class parents are increasingly allowing their children to decide when they want to make the transition out of nappies, which is leading to less children being potty trained before the age of two, as NHS guidelines advise. Philip Hodson from the UK Council for Psychotherapy said that child-led potty training is a “terrible” idea and that “being incontinent by the time you start schools turns a child into a problem”.

Anglesey Council U-turn on parents needing to prove age of child to have nappies collected

Anglesey Council has reversed its plans to make it mandatory for waste management teams to collect dirty nappies only if parents have shown their children’s birth certificates to prove they are aged three or under. The decision was made based on evidence that most children are potty trained between the ages of two and three. The nappy collections were to happen fortnightly, and those unable to prove their child’s age to be under three were to put soiled nappies with their household waste, which would have only been collected every three weeks. However, it has been revised after Rhun ap Iorwerth AM (Plaid Cymru, Ynys Môn) said he had contacted the council and understands that the request for birth certificates will be dropped, and the age limit increased to four.

The council does provide a separate service for families with older children with health conditions, which is given upon request from the relevant healthcare provider through a prescribed application form. Despite this, parents in Anglesey who have disabled children voiced their concerns over the scheme aimed at increasing recycling in the area, as it was a blanket ban and did not consider individual children’s needs. A resident commented that her three-year-old is still undergoing potty training, and that she is “not the only one in the same situation”.

Rhia Favero from ERIC, the Children’s Bladder and Bowel Charity commented on the council’s original plans, and said that not all children will be able to be potty trained by the age of two, “especially if a child develops a bladder or bowel problem like a urinary infection or constipation”. Ms Favero also commented that families need to be informed on how to potty-train their children at their two-year nursery development reviews, because more teachers are reporting that children are starting school in nappies.

Round-up of the Labour Party’s Annual Conference

This week, the Labour Party held its annual Party Conference in Liverpool. Following Jeremy Corbyn’s landslide re-election to the Labour leadership, his address to the Conference sought to elaborate on the way forward for the party during Brexit. However, further tensions within the party seem likely following Corbyn’s lack of commitment to curbing immigration: many Labour MPs are now arguing that the Party needs to recognise that many of its working class supporters voted to leave the EU because of their concerns on this.

Shadow Health Secretary Diane Abbott MP used her speech to condemn the Health Secretary’s contract dispute with NHS junior doctors, which has been officially upheld by the High Court this week. She promised that Labour would oppose any move made by the Government in the Brexit negotiations which would compromise EU workers in the NHS; and that Corbyn’s Labour Party will be committed to halting and reversing the supposed ‘privatisation’ and ‘marketisation’ of the NHS.

Angela Rayner MP, Shadow Secretary of State for Education, was received well by the Conference, as she announced that Labour will launch a childcare taskforce to transform early years education. Ms Rayner positioned this announcement in opposition to the Conservative Government’s life chances strategy, which was introduced by former Prime Minister David Cameron but has since been delayed and subjected to criticism. The taskforce will be chaired by Liz Snape, Assistant General Secretary at UNISON, and will aim to improve access to affordable childcare and early-years learning.

The National Children’s Bureau publishes report on school nurses

A report has been published by the National Children’s Bureau on the role of the school nurse, exploring what health needs and long-term conditions are the most common issues dealt with by nurses, along with school nurses’ satisfaction and morale. The report asked questions about asthma, epilepsy, anaphylaxis, eczema and diabetes, as they were identified as the most prevalent long-term health conditions.

Nearly two thirds (61%) of the school nurse survey respondents said that they had experience of working with all the named long-term conditions, and that the most common activities they undertook were educating staff about the conditions (91%), making and receiving referrals (82%) and creating individual health care plans (79%). Overall, only 12% of respondents said they lacked motivation and most school nurses felt that they are a dedicated workforce. Of those who had been in their role for two years or more, respondents said that they felt more confident in carrying out their work.

The report also highlights research that has shown the positive effects of having full-time school nurses in schools on pupils’ academic work and wellbeing. It is emphasised that for pupils with long-term health conditions, school nurses have been shown to be integral in ensuring they are supported and are provided with a link between home- and school-life.

Welsh Government launches Healthy Child Wales Programme

It has been announced by the Welsh Government that it will implement the Healthy Child Wales Programme (HCWP) across all Welsh health Boards from 1 October 2016. The HCWP is one of the Welsh Government’s priorities in its programme for government, Taking Wales Forward 2016-21, and aims to establish a universal health programme for all families with children from the ages of 0-7.

Rebecca Evans, Welsh Minister for Social Services and Public Health, said that the programme represents the Welsh Government’s commitment to “tackle the significant challenge that child poverty has on delivering improved health outcomes”. It has a range of evidence based preventative and early intervention measures, and advice and guidance to support parenting and healthy lifestyle choices. Universal, planned contacts which families can expect to receive from their Health Boards are set out, covering screening, immunisation and monitoring and supporting child development from maternity services to schooling.

World champion athlete Denise Lewis reports on ‘taboo’ of continence and supports the #pelvicfloorweek in Huffington Post Lifestyle

This week was the UK’s first ever Pelvic Floor Week, and Denise Lewis, world champion athlete and blogger for Huffington Post Lifestyle, has openly spoke about the incontinence issues she faces due to her athletics career and pregnancies. She calls on people who are affected by incontinence to start talking about it in order to make the condition less taboo, and to educate people on the importance of a strong pelvic floor to help prevent it.

Lewis discusses how she did not have any problems until she had her most recent child, after which she neglected to do pelvic floor exercises which led her to having incontinence problems. She endorsed the new Pelvic Floor Week and the accompanying Twitter hashtag campaign #pelvicfloorweek.

Weekly political news round up – 23rd September 2016

October 24, 2016 in News by Whitehouse

Overview

This week, the Health Select Committee has invited written submissions on what the priorities for health and social care should be in Brexit negotiations, and two parliamentary written questions have been answered on school nursing and toilet training. The Council of Deans of Health has published a report revealing the gap between national strategic priorities and funding decisions and its implications for the NHS workforce; while the former Conservative Health Secretary Lord Lansley has said the NHS should receive a £5 billion “Brexit bonus”.  The RCGP has also warned that 600 general practices are at risk of closure due to a looming recruitment crisis, and junior doctors have taken their ongoing contract dispute with the Secretary of State for Health to the High Court.

Health Committee launches Brexit health and social care inquiry

The Health Select Committee has invited written submissions to its inquiry on the priorities for health and social care in Brexit negotiations. Having received a wide range of evidence on what affects this policy area in their pre-referendum inquiry into the impact of EU membership on health and social care, the Committee now wants to know what issues to prioritise in its scrutiny of the withdrawal process.

Specifically, the Committee is asking for:

  • Views on the risks and opportunities for health and social care from Brexit; and
  • How the Government can mitigate risks and take advantage of the opportunities presented by the negotiations.

Submissions will address matters the Secretary of State for Health is responsible for, including all areas of health policy, financial control and oversight of NHS delivery and performance. Comments are also welcomed on other matters that have implications for health and social care in England but which the Health Secretary does not have accountability for, such as free movement of labour and the Single Market.

The Committee emphasises that the inquiry does not seek to cover all of the health and social care issues that will arise from Brexit negotiations: the inquiry’s main aim is to establish the priority issues for the negotiations. Examples of these priorities include EU Directives affecting health and social care, and the impact of free movement on NHS staffing.

Parliamentary Written Question answered on school nurses

Diane Abbott MP, the Shadow Secretary of State for Health, has recently asked the Secretary of State for Health “what assessment his Department has made of the effect of changes in the availability of health visiting and school nursing services on health outcomes for children and young people”. Her question was answered this week by Philip Dunne MP, Minister of State for Health.

Mr Dunne’s answer explained that while local authorities are now responsible for health visiting and school nursing, Public Health England still monitors a range of health outcomes for children. However, he said this does not include data collection for school nursing services and therefore no assessment has been made. He highlighted that the National Child Measurement Programme and childhood immunisations have seen significant uptake rates.

Dunne also referenced the Health Visitor Programme and School Nurse Programme, which saw the workforce increase and more families being reached before ending in 2015. He concluded that “both professional groups indicate the service models have increased awareness of the services by users and a better structured delivery”.

The Health Visiting Programme began in 2011 with the aim of creating a universal health visiting service, which has increased the numbers of health visitors by 50% and has been deemed to have made a positive impact on the service. The School Nursing Programme intended to promote school nurses contributions’ to improving health outcomes for children, young people and their families: however, in delegating responsibility for school nurses to local authorities as opposed to NHS England, many believe school nurses are often not a priority.

Parliamentary Written Question answered on accessible public toilets

The Secretary of State for Communities and Local Government has been asked by Karl Turner MP “if he will bring forward legislative proposals for the mandatory provision of accessible toilets by all public organisations and private businesses for their customers and service users”. Mr Turner’s question was answered by Gavin Barwell, Minister for Housing, Planning and London.

Mr Barwell said there are building regulations and statutory guidance on the requirements public organisations and private businesses must follow in relation to toilet provision and sanitary accommodation. The Government has no plans to amend the requirements, “but will keep guidance on toilet provision under review”. He then cited the Equality Act 2010, which places a duty on building owners, employers and business operators to make considerations and “reasonable adjustment” to building features to accommodate disabled access to toilets.

Council of Deans of Health report reveals gap between national aims and funding decisions on nursing education

The Council of Deans of Health have published a report that considers the extent of Continued Professional Development (CPD) cuts for nurses, midwives and Allied Health Professionals (AHPs) in England for 2016-2017. The report establishes the impact of the cuts on the NHS and its workforce, and whether these cuts are likely to undermine the NHS achieving its strategic objectives, and the Government’s policies on nursing, midwifery and AHPs in England. It argues the Government must recognise the gap between national strategic priorities and funding decisions, and the consequences for nursing education.

The authors suggested that because most of the health professionals that will be in the NHS workforce in twenty years are already there, CPD is vital to sustaining NHS services and providing specialist training. It was found that some students already fund their own CPD and are considering more options for self-funding. Interviewees also stressed the difference between CPD and career pathways for medical staff and other professions, and that despite the intention of Health Education England to deliver a multi-profession approach to funding allocations, the aspiration had not been delivered.

The Chair of the Council of Deans of Health, Professor Dame Jessica Corner, said in a speech at the Queen’s Nursing Institute this week that the switch from bursaries to loans for student nurses, midwives and allied health professionals could increase training places, but it is unclear where the accompanying placements would come from. There was strong agreement that unless investment was made into community roles and leadership in the community, the NHS could struggle to deliver community care.

Former Health Secretary believes NHS should be awarded £5 billion “Brexit bonus”

Lord Lansley, former Conservative health secretary for David Cameron, has attacked Simon Stevens’ plans to make further cuts to the NHS, which could make the system go “back in time”. In a speech to NHS Providers, the organisation representing hospitals, he also declared that the NHS should receive a £5 billion a year “Brexit bonus” after the UK leaves the EU, and questioned why the health service should not receive a commitment to increasing funding as a proportion of GDP like international aid and defence budgets.

The speech coincides with the Government pledging to keep the NHS funded by general taxation and free at the point of access. It was made in response to new projections from the Office for Budget Responsibility, which showed that NHS spending would have to rise from the current £139bn to as much as £234bn by 2030 to it remain functional.

Weekly political news round up – 16th September 2016

October 24, 2016 in News by Whitehouse

Overview

This week, the Children’s Commissioner released a review that found school nurses are prevented from carrying out their jobs because of paperwork. The Sun has reported on the increasing trend amongst English parents to encourage their children to use potties from birth as opposed to relying on nappies. NHS England has announced it will make working in traditional health care systems – such as standalone GP practices – less desirable, in order to implement new care models they have trialled; and the NHS’s Chief Executive Simon Stevens has warned of the ‘uphill struggle’ the NHS faces.

Children’s Commissioner review exposes ‘red tape’ that prevents school nurses from doing their jobs

A review by the Children’s Commissioner in to children’s access to school nurses has revealed that nurses are increasingly having to take on cases rejected by social workers, and have less contact time with school children due to administrative tasks. Anne Longfield, the Children’s Commissioner, found that the time spent on paperwork is reducing school nurses’ abilities to identify children at risk of abuse or neglect.

Out of the 800 nurses surveyed, 40% answered that they were often dissatisfied with social worker’s responses to referrals and a fifth said their caseload, paperwork and other activities were limiting their ability to fulfil their roles. Specifically, school nurses believe the promotion and support of children’s health and wellbeing, mental health, relationships and sex education are being compromised.

The review also found that: school nurses were often playing a reactive as opposed to a proactive role in schools; the majority of children and young people in the schools they work in were unaware of their service and safeguarding; and child protection duties are a substantial part of school nurses’ duties.

Councillor Izzi Seccombe, Chairman of the Local Government Association’s Community Wellbeing Board, said that “councils want to see school nurses being able to work directly with children” instead of doing paperwork. However, she emphasised that “paperwork is generally not generated by commissioners, but as a requirement of the safeguarding process”. She called for more government investment in local services to ensure school nurses are able to fulfil all of their responsibilities towards the children in their school.

The Sun reports on the increasing nappy-less trend

The Sun has reported on an increasing trend among parents to encourage children to use a potty from birth, as opposed to relying on nappies. The method is called ‘baby-led potty training’, and it requires parents to pay attention to their child’s daily routine to find out what is the best position for the child in order to go to the toilet – potentially saving an average of £1,250 on nappies. The article states that a common position is to rest the back and head of a baby against the chest of the parents, with their legs held in a squat position.

The article spoke to Jen Philpott, a woman who runs a baby-led potty training advice service online, about the various techniques and tricks she offers to parents. She claims that the method can fully potty train a child by the age of 18 months, as it emphasises letting a baby’s natural instincts prevail when using the toilet.

NHS England to make working in traditional healthcare systems ‘progressively less attractive’

In a bid to extend new care models across 50% of England’s population by 2020-2021, NHS England will actively look to make traditional healthcare systems – such as standalone GP practices – ‘progressively less attractive’. However, at present it is unclear how it intends to do so, as details on the new care models and vanguard sites are continually emerging. Speaking at a Westminster Health Forum seminar, national lead for the New Models of Care Programme Jacob West said that a “multifaceted and quite sophisticated approach to supporting and encouraging local health and care systems” is needed.

2016 is the second of the three-year vanguard programme that has introduced new models of care to 50 sites in England, like multispecialty community providers and primary and acute care systems. The third and final year of the programme is going to be centred around mainstreaming the trialled models of care.

NHS Chief Executive warns of uphill struggle due to funding shortages

Simon Stevens, NHS England’s Chief Executive, has dismissed ministers’ claims that the NHS has been given all the money it needs and has instead warned that the promised extra £10 billion each year has been “back-ended to 2020”. He believes that the NHS has “a bigger hill to climb” than first envisaged when it entered discussions with the Government on receiving increased funding as part of the Five Year Forward View.

Whilst giving evidence to the Public Accounts Select Committee, Stevens disputed the claims of ministers who have persistently argued the NHS does not face a crisis because it has been “given the money it asked for”. Stevens said thus far it has only been getting “broadly what [the NHS] asked for” and that the overall £10 billion package was at the “lower end of the range” of what was originally requested, which was almost £21 billion. There has also been controversy over the amount of the funding “frontloaded” to earlier in the Parliament – a report by the Health Select Committee recently concluded that claims that £6 billion of the additional £10 billion for the NHS was frontloaded, this has been offset by cuts to public health and training budgets.

Weekly political news round up – 9th September 2016

October 24, 2016 in News by Whitehouse

Overview

This week, The Times reported on a survey conducted by the Association of Teachers and Lecturers that revealed 70% of primary school teachers have seen an increase in the number of children wetting or soiling themselves at school. Five parliamentary questions have been answered of relevance to the PCF; and Cardiff City Council has unveiled its ‘public convenience strategy’ to improve public toilet access.

Another survey has brought to light the incontinence problems faced by women after giving birth, with 38% of those who developed neo-natal incontinence feeling “self-conscious” about the problem with a clinician. The King’s Fund Quarterly Monitoring Report on NHS performance has highlighted that 23% of CCGs are predicting deficits going in to 2017. Finally, the £170 million pharmacy cuts planned for October 2016 have been halted by Parliamentary Under-Secretary of State for Community Health and Care, David Mowat MP.

70% of primary school teachers have noticed an increase in bed wetting and soiling

A survey carried out for the Association of Teachers and Lecturers (ATL) has revealed that 70% of primary school teachers have noticed an increase in the number of children aged three to seven wetting or soiling themselves at school, compared with data from five years ago. The figures build on previous surveys conducted by the union which presented similar findings; with the ATL’s President, Shelagh Hirst, suggesting that rather than the “odd child” experiencing an accident at school, there are now often two or three children in each reception class with wetting and soiling issues.

Hirst believes that working parents, who do not always succeed in toilet training their children and rely on stay-dry nappies as a result, are possible factors contributing to the increase.  She further suggested that the new technology in stay-dry nappies preventing children from feeling “wet, cold or uncomfortable”, along with changing childcare arrangements, could be exacerbating difficulties.

Written questions on school nursing and accessible toilets answered in the House of Commons

This week, several written questions have been tabled of relevance to the PCF. The first, tabled by the Shadow Minister for Housing, Dr Roberta Blackman-Woods MP, questioned what assessment the Department of Health “has made of the reasons for the reduction in the number of school nurses since 2010.” Parliamentary Under-Secretary of State for Health, Nicola Blackwood MP, answered the question, saying that “since April 2013, local authorities have been responsible for […] health services for school aged children” and that no formal assessment has been made by Public Health England on the recent changes to school nursing numbers. She then explained that PHE published commissioning guidance in January 2016 and works with different partners to support school nursing teams and local delivery.

The Shadow Solicitor General, Karl Turner MP, also asked the Secretary of State for Communities and Local Government “what steps the Government is taking to encourage business owners to provide accessible toilets for customers.” Gavin Barwell MP, Minister for Housing, Planning and London for Communities and Local Government, replied that building work being carried out on non-domestic buildings needs to comply with building regulations on accessible toilets and sanitary provision. Barwell also referenced the Changing Places Toilets campaign, “which provide facilities for severely disabled people” and has recently developed a website that provides “guidance on the location of and facilities contained in ‘Changing Places’” toilet facilities.

Written questions on UTIs and NICE guidelines answered in the House of Commons

Three written parliamentary questions have been tabled this week on Urinary Tract Infections (UTIs) and the corresponding NICE guidelines. The first question asked “what discussions [the Secretary of State of Health] has had with NICE about the effectiveness of guidelines to tackle urinary tract infections that are (a) acute and (b) chronic”. Public Health and Innovation Minister, Nicola Blackwood MP, answered that no discussions had taken place with NICE, and referred to NICE’s clinical guidelines on diagnosing UTIs in both children and young people and adults.

The second question asked “what steps [the Secretary of State] is taking to improve the accuracy of diagnosing chronic urinary tract infections”. Parliamentary Under Secretary for Health, David Mowat MP, answered by describing what UTIs are and said that NICE publishes standards to define diagnosis and treatment of the condition.

Lastly, Mulholland asked “whether he [the Secretary of State for Health] had representations on the research conducted by Professor Malone-Lee and University College London researchers on the effectiveness of the standard NHS tests for diagnosing urinary tract infections”. To the last question, Mowat replied saying that the ministers had received twelve items of correspondence about the research since 1 January 2016. He went onto describe that “NHS commissioners are responsible for making decisions on individual treatments” on the basis of evidence and NICE guidelines.”

Cardiff Council unveils ‘public convenience strategy’

Cardiff Council has drawn up a ‘public convenience strategy’ to make toilets more accessible in the city, a council report has revealed. Within the strategy different options are debated, such as expanding a community tax levy to fund new facilities. It rules out closing toilets despite the provision not being statutory, because the council understands community toilets’ importance. The report puts forward five suggestions, including making new buildings have publicly accessible features as part of their design, and local authorities identifying existing toilets they can signpost.

Last week the Welsh First Minister, Carwyn Jones AM, confirmed the Welsh Government will reintroduce the Public Health (Wales) Bill to the Welsh Assembly in September, as one part of its legislative agenda for the coming months.

Women suffering in silence over neo-natal incontinence problems

A new survey has found that 38% of women who developed incontinence after giving birth were “self-conscious” around clinicians when speaking about the problem. In the survey of 1,515 women, carried out by the National Childbirth Trust (NCT), 33% and 46% of women who developed urinary incontinence after childbirth were embarrassed to talk about it with their partner and friends respectively.

The NCT’s head of knowledge, Dr Sara McMullen, described the figures as “worrying” and emphasised the need to break the “taboo” of continence issues to improve the lives of the women affected by it. Jacque Gerrard from the Royal College of Midwives (RCM) said “midwives are best placed to provide support and women should not feel embarrassed” about neo-natal incontinence issues they may experience.

Government delays plans to cut community pharmacy funding by 6%

Health Minister David Mowat has announced that the Government is delaying the decision to cut community pharmacy funding by 6%, in a speech to the Royal Pharmaceutical Society’s Annual Conference. He said the decision has been made in order to “make sure that [the government] is making the correct decision”. There has been a sustained campaign against the cuts, and the Local Government Association warned earlier this year that community pharmacies could go out of business because of the planned funding reductions. The industry has argued that community pharmacies are well-placed to provide an array of services to patients, particularly to elderly and vulnerable people, which makes the prospect of pharmacy closures significant.

Ian Strachan, National Pharmacy Association Chairman, commented that he was “delighted” that the funding cuts scheduled for October are not going to happen, but the promised dialogue Mowat had committed to must be meaningful and “draw on the experience of front line community pharmacists”. The confirmation of the decision was made shortly after an Early Day Motion was tabled in the House of Commons by Alan Meale MP, highlighting the petition handed to Parliament protesting the planned cuts, which received more than two million signatures.

Weekly political news round up – 2nd September 2016

October 24, 2016 in News by Whitehouse

Overview

This week the Welsh First Minister, Carwyn Jones AM, has confirmed the Welsh Government will reintroduce the Public Health (Wales Bill) to the Welsh Assembly in September, as one part of its legislative agenda for the coming months. The previous Public Health (Wales) Bill narrowly missed becoming law earlier this year due to opposition to proposals on e-cigarettes; and the new iteration could likely push forward the previous proposals on public toilet access. The former Health Minister, Dr Dan Poulter MP, has also called for National Insurance contributions to be increased by 1p in the pound to better fund the health and social care system.

The Health Select Committee also released its report on public health provision post-2013, which explored the experiences of health professionals involved with the move of public health services to local authorities. A report into district nursing published by the King’s Fund found that elderly people are at risk due to a decline in the number of district nurses, but neglected to address children’s experiences with district nursing. Finally, the BMA has released proposals to reduce the number of patients GPs see each day; and in a historic move, has approved junior doctors’ plans to stage five-day national strike action.

Health Select Committee releases report on public health post-2013

The Health Select Committee has published a report on the changes to public health provision since 2013. The report welcomes Prime Minister Theresa May’s commitment to tackle health inequalities, but highlights the need for public health measures to coordinate with other policy areas – such as education and employment – to address the wider determinants of health. The Committee believes local authorities are “well placed” to improve public health, but cuts to public health services are a “false economy” as they add to the future costs of health and social care.

The report explores the impact of last year’s £200 million budget cuts to local authorities, despite councils assuming more responsibility for public health. The Committee believes that there is now a gap between public health spending and the significance attached to prevention in the NHS Five Year Forward View. Within the report, school nurses are described as being a part of the “core” of the public health workforce. It cites the testimonial of a school nurse from an informal evidence session held as part of the inquiry, who stated that school nurses “do not have a hope” of being able to deliver the “wonderful service level agreement” they were promised by their local authority in 2014 due to spending cuts.

More generally, the Committee heard varying opinions on the effect of recommissioning NHS services to local government. Some claimed that services were being restricted or were of a poor quality; however, others said the new arrangements have resulted in services being better value for money, better matched to local needs and more accessible for service users. In the new public health system, “boundary issues and fragmentation” are mentioned as recurring problems for commissioned public health services, due to the divisions between different bodies. It recommends that where boundary issues are present, PHE should set out options to resolve them in the interests of patients and the public.

The Committee calls for a minister in the Cabinet Office to be given specific responsibility for embedding health across all areas of Government policy. It also recommended that local authorities should be given greater powers to improve the health of their communities, such as “including health as a material consideration in planning and licensing.”

King’s Fund publishes report on understanding quality in district nursing services

A report published by the King’s Fund has examined care for older people who receive district nursing services in their own homes, finding  that a significant decrease in district nurse numbers has left staff “exhausted” and the elderly vulnerable. Over the past five years, the number of district nurses has fallen by 28% to under 6,000, and the community nurse workforce has shrunk by 8% to 36,000.

While the report does not go into great detail on continence care, continence management is listed as a common service provided by district nurses, as well as a speciality area provided by clinical nurse specialists. Those interviewed listed specialist continence nurses as playing a “valuable” role in co-ordinating care from other professionals and services, and said they often act as an “advocate” on behalf of patients and carers.

The report puts forward seven recommendations, including: renewing efforts to establish robust national data on capacity and demand; developing meaningful oversight for care delivered in people’s homes; and creating a more sustainable district nursing workforce. A follow-up article by Anna Charles, a policy researcher for the King’s Fund, explored what is “unknown” in district nursing services, such as the difficulty in obtaining datasets on the people who use community services.

BMA sets out new proposals to reduce GPs’ workload

The British Medical Association has proposed that GP consultations should be lengthened to fifteen minutes each (up from ten minutes) and limited to a maximum of 25 consultations per doctor per day, to ensure patients receive adequate attention and prevent GPs being overworked. The Safe Working Levels in General Practice report included further details on ‘locality hubs’, previously described in NHS England’s GP Forward View, which could provide central facilities to manage demand, patient lists and safe working lists for multiple local practices. These would seemingly offer additional appointments to relieve pressure from individual practices, with same-day appointments as one option. Dr Brian Balmer, an executive team member of the BMA’s GP Committee, commented that “we need a new approach that shakes up the way patients get their care from their local GP practice.”

The BMA has also announced that junior doctors will stage unprecedented national five-day strike action every month until the Health Secretary, Jeremy Hunt MP, withdraws his proposed imposition of junior doctor’s new contracts. Hunt said the strikes would “cause misery” for patients due to the expected cancellation of 100,000 operations, and Prime Minister Theresa May accused the BMA of “playing politics”. The strikes are set to begin on 12 September.

Weekly political news round up – 26th August 2016

October 24, 2016 in News by Whitehouse

Overview

This week, the NHS provider sector has released figures showing a £461 million deficit for the first quarter of the 2016/17 financial year, compared with a deficit of £930 million for the same point in 2015/16. Although this has been largely reduced by £450 million of funding from the Department of Health’s sustainability and transformation fund, this still indicates financial performance was £5 million better than anticipated.

RCN School Nurses Conference highlights school nursing shortage

The Royal College of Nursing (RCN) has called for the Government to protect school nursing positions in the wake of statistics showing the number of school nursing posts has declined by 13% since 2010, leaving 2,606 working in the NHS. The College’s Professional Lead for Children and Young People’s Nursing, Fiona Smith, emphasised that “school nurses are there for all children and young people, providing support, encouraging healthy lifestyles and protecting those who are most vulnerable.” She said the Government should not be cutting these roles, and alluded to the additional capacity pressures school nurses are now facing.

The RCN made the appeal in the context of the role school nurses have in delivering sex and relationships education, with 5,500 sexual assaults occurring in schools between 2011 and 2014. The organisation believes school nurses are essential in providing sex education, especially at a time when “it has never been so important to equip [children] with a solid understanding of healthy relationships.”

IPPR warns NHS needs EU employees

The Institute of Public Policy Research (IPPR) has released a report warning of the consequences of EU nationals working in the NHS being sent home following Brexit, suggesting it could result in the collapse of the health service. Approximately 10% of the NHS’s workers are from the EU, and of these 57,000 employees, 7,000 are consultants or specialist registrars and 21,000 are nurses and health visitors. The report’s author, Chris Murray, said unequivocally that “Without them the NHS would collapse.”

As there is uncertainty concerning whether EU citizens will be able to remain in the UK after it has left the EU, the think tank contends it is already affecting decisions by EU citizens to come and work in the UK, and could continue to do so. It has proposed solutions such as: removing the £1,200 fee for UK citizenship for NHS workers; entitling EU nationals who have lived in the UK for more than six years to citizenship; and offering automatic indefinite leave to remain to current EU residents in the UK.

Risks of seven-day NHS highlighted in leaked Department of Health report

The Department of Health has compiled a list of thirteen risks to the plans for a seven-day NHS which has been leaked to the media. The threats highlighted include the risk of workforce overload, a lack of funding and the impact of Brexit, with the combination of these meaning that a full seven-day service “cannot be delivered”. Additionally, workforce morale is seen as a hindrance to the plans, as many staff do not “believe in the case for change” given the questions raised about the academic studies used to support the policy. The briefing also advised the Health Secretary, Jeremy Hunt MP, to stop talking about the “weekend effect” in support of the policy.

In response to the concerns, the BMA’s chair Dr Mark Porter said the document was evidence that the seven-day NHS is “nothing more than headline-grabbing soundbite set to win votes rather than improve care for patients.” The Shadow Health Secretary, Diane Abbott MP, called the revelations a “scandal” and accused the Government of “undermining the NHS with plans it knew to be unworkable.”

Labour leader promises to “renationalise” NHS

The leader of the Labour Party Jeremy Corbyn MP has made a speech on the NHS as part of the ongoing leadership contest in the party, promising to remove private provision and “renationalise” the NHS if he became Prime Minister. He said that a future Labour government “would deliver a modern health and social care service that is fully publicly provided and fully publicly funded”, which would include ending PFI contracts, restoring bursaries for nursing and midwifery students, and working towards ending private provision.

The speech was followed by an article from the Shadow Health Secretary Diane Abbott outlining the issues facing the NHS and how a Labour government would approach them, saying “Jeremy Hunt has misled parliament and the British public”. She further accused the Government of underfunding the NHS by reducing spending as a proportion of GDP, and said she would “closely examine the scope to shift to generic drugs and away from more expensive brands” as a means of saving money.

Weekly political news round up – 19th August 2016

October 24, 2016 in News by Whitehouse

Overview

This week, The Daily Mail reported on the number of GPs and sufferers who misunderstand constipation, while a trial for reviewing urology referrals to determine whether they can be sent back to a patient’s GP rather than a specialist has been criticised by its Local Medical Committee. Concerns have been raised regarding the increasing paediatric services vacancy rate; and a letter to The Times has warned of the consequences of cutting health visitors.

Misunderstanding of constipation covered by the Daily Mail

An article in The Daily Mail has highlighted how misunderstanding of constipation among GPs and the public, and subsequent delays in receiving appropriate treatment, can worsen the problem. The feature discussed the case of a woman who suffered with severe constipation, and was consistently advised to eat more fibre and prescribed laxatives. This was in spite of the fact that her problem was caused by having a slow transit time and so was worsened by these treatments. Her constipation was eventually eased through the use of biofeedback and eating less fibre.

While the remainder of the article focused on adults, comments from consultant paediatrician and PCF member Dr Anne Wright argued that constipation among children is still “a real taboo subject” affected by the perception they will grow out of the problem. Professor Julian Walters, a consultant gastroenterologist at Imperial College Healthcare, also said that often “if [patients] had been referred earlier, they could have had a transit study done and got the right treatment.”

Cases sent back to GPs under urology referrals pilot

A pilot scheme for referrals from GPs to urology specialists in Northern, Eastern and Western Devon CCG has resulted in many referrals being sent back to GPs. The initiative involved consultants evaluating all GP urology referrals to ascertain whether the patient should receive specialist outpatient treatment or be sent back to their GP with a management plan and recommendation for further tests with the GP, such as pre- and post-voiding ultrasounds and CT scans. The Devon Local Medical Committee (LMC) expressed concerns that one third of these referrals were sent back to the GP during the six-week trial – and despite the work this could incur for GPs, the CCG intends to extend the method to other specialties.

The CCG argued that the approach decreased the length of time it takes to solve a problem for a patient; to which the Devon LMC’s executive countered that it “related almost entirely to cost reduction, and appeared not to give sufficient consideration to safety and quality or to increased GP workload.” The LMC also warned that the expansion of the scheme could “crush practices and destabilise core general practice services.”

Concerns raised over paediatric services vacancy rate

The Royal College of Paediatrics and Child Health’s (RCPCH) annual workforce census has revealed that the vacancy rate among junior doctors in paediatrics rose to a six-year high of 15% in 2014/15. The vacancy rate has fluctuated between this and 9% since 2009/10; and was worse among tier two paediatric units than tier one units last year. The RCPCH responded to the figures by reiterating its previous warning that further investment and reorganisation is needed among the paediatric workforce if it is to be sustainable in the future.

89% of clinical directors surveyed were concerned about how their services will cope in the coming six months. The RCPCH’s Workforce Officer, Dr Simon Clark, called for NHS leadership “to break down barriers to multi-disciplinary working, an increase in children’s nurses and immediate opportunities for our GP colleagues to access child health training.” The College also suggested the junior doctors’ contract disagreements may have impacted recruitment in 2015/16, as 100% of posts were filled in the devolved nations unaffected by the new contract compared with 93% in England.

Letter to The Times warns of consequences of cutting health visitors

The NSPCC, Royal College of Nursing (RCN), Royal College of General Practitioners (RCGP) and Royal College of Paediatrics and Child Health (RCPCH) have written a joint letter to The Times warning of the “irredeemable consequences for children and families” behind ending the drive to recruit more health visitors and cutting their numbers further. The number of health visitors declined from 10,185 in March 2015 to 9,711 in April 2016, after the coalition government made a pledge to hire 4,200 more between 2010 and 2015 under the Health Visitor Implementation Plan. Janet Davies, chief executive of the RCN, said “The previous government’s boost to health visiting services was a vital step forward, yet these cuts risk any gains that were made and are a waste of that financial investment.”

The cuts are attributed to the transfer of the commissioning of health visitors from the NHS to local authorities in 2015; and the RCN further said that health visitors are “too important” to be neglected due to financial pressures on local authorities. A survey by the union Unite – who also signed the letter – has similarly found that 86% of health visitors always or frequently work more than their contracted hours, while 44% have experienced decreased workplace morale and 58% have seen significant increases to their workloads.