Weekly political news round up – 20th January 2017

January 20, 2017 in News by Whitehouse

Overview

This week, Public Health England (PHE) has published its service specification for local authorities commissioning health visitors and school nurses, for public health services for children aged 0-19. The specification contains four commissioning guides to support the commissioning of the Healthy Child Programme 0-19, to take advantage of the “new opportunities for bringing together a robust approach for improving outcomes for children and young people across both health and local authority led services”.

As continence is considered a clinical need rather than a public health need by PHE, the second document states that “commissioning clinical support for children with additional health needs or long-term conditions and disabilities, clinical support for enuresis or incontinence lies with NHS England and [CCGs], to ensure co-ordinated support across the life course.” However, the document also suggests that to achieve the outcome of “More children and young people develop and achieve their potential, through improved rates of school attendance”, there should be “Identification of continence issues and referral to appropriate services.”

The NHS’s funding challenges also continued to feature in the media, with HSJ reporting the Government’s sustainability and transformation process could see thousands fewer nurses and other staff employed in years ahead and an East London Trust announcing a 20% reduction in its community nursing team. In an article penned for the Guardian, former head of the civil service Bob Kerslake said that the pressures on the NHS are real and serious, and praised senior and frontline staff for their “extraordinary efforts” to keep essential services running. He said it is not surprising that the Government is standing firm on the funding agreed in the Five Year Forward View, but that NHS Chief Executive Simon Stevens was both right and courageous to challenge the Prime Minister’s stance last week; to stick to current funding arrangements would be a “profound mistake”.

Wider headlines were dominated by the Prime Minister’s speech outlining her strategy for Brexit and confirming speculation that she will not pursue maintaining membership of the Single Market. In the speech, May said she seeks a “fairer, more secure, united and outward looking” UK that will remain a “good friend and neighbour” to the EU, but highlighted that maintaining Single Market membership and gaining greater control of immigration are incompatible aims. Her statements were underpinned by a 12-point Brexit plan, which focused on strengthening the Union between the four nations of the UK, controlling immigration, protecting workers’ rights, and establishing the UK as a “great, global, trading nation” based on ambitious Free Trade Agreements with the EU and other countries. She also confirmed that the final Brexit deal will be put to a legally-binding vote in both Houses of Parliament. However, she did not indicate what kind of immigration system she would envisage for the post-Brexit era, an omission that will continue to cause uncertainty for the NHS.

MPs debate toilet facilities for the disabled

This week, MPs held an adjournment debate on community toilet facilities for people with disabilities, after Stalybridge and Hyde MP Jonathan Reynolds raised the issue on behalf of his constituent Brian Dean. Mr Reynolds related how Mr Dean – who suffers from Parkinson’s and has continence issues – had experienced difficulties finding a suitable toilet when returning from a trip to Blackpool, leading him to wet himself. Mr Dean had been left demoralised, he said, but had turned his anger into action and launched an appeal for a nationwide solution, calling for as many businesses as possible to provide an accessible toilet.

Mr Reynolds asked the Minister to evaluate current public sector accessible toilet provision across the nation, and how Parliament can work with local authorities to prevent further toilet closures. He also asked him to assess how many community toilet schemes are currently operating in the UK, and how we can ensure universal coverage of these, putting forward the suggestion of a national scheme. He furthermore called on him to lend his support to the Changing Places toilets scheme to ensure greater numbers of larger, better-equipped toilets exist for those who need them.

Responding on behalf of the Government, Housing and Planning Minister Gavin Barwell thanked Mr Reynolds for raising the issue, stating that “Part M” of local building regulations sets out minimum standards for accessible toilets in buildings when they are built or undergo major refurbishment. The Minister recognised that people’s needs and expectations change over time and that the Government must adopt its approach in response. He said that the Government has commissioned researchers to check that the current requirements in Part M remain fit for purpose, including the design and provision of accessible toilets, and that they would report later in the year.

Mr Barwell also said that local authorities have an important role to play in identifying how accessible toilet provision can be supported, and can provide accessible toilets directly, but are under no obligation to do so. He said the Local Government Finance Bill will allow councils the flexibility to use their existing discretionary relief powers to support publicly owned public toilets from 1 April 2018, adding to the powers they already have in relation to privately run toilets. Finally, Mr Barwell said there is a clear precedent for community, business and public sector leadership delivering improvements in accessible toilet provision through the success of the Changing Places campaign, and that the Government will continue to enhance provision through this scheme.

Written question tabled on school nurses

The Parliamentary Under Secretary of State for Public Health and Innovation, Nicola Blackwood MP, has responded to a written question tabled on school nurses in the House of Commons. Huddersfield MP Barry Sheerman had asked what steps the Department of Health (DH) is taking to support school nurses and the services they provide to disabled children in schools, referring to the report Disability Matters in Britain 2016.

Ms Blackwood responded that the DH and Public Health England (PHE) have produced guidance to support both commissioners and local providers, including the 0-19 commissioning guidance, and said that the DH and PHE are working with the Local Government Association and locally through PHE Centres to share evidence and guidance. She added that school nurses are not generally commissioned to deliver clinical support for children with disabilities – and that this function would be commissioned by CCGs, and may be provided by community children’s nurses or specialist school nursing services.

House of Commons to debate nursing pay

The House of Commons is set to debate nursing pay on 30th January, after a petition urging the Government to scrap an NHS pay cap of 1% reached 100,000 signatures. Initiated by community nurse Danielle Tiplady, the petition argues that Agenda for Change staff including nurses, midwives, healthcare assistants and associated healthcare professionals have experienced a pay restraint since 2010 and lost more than 14% of their pay in real terms.

The Department of Health has already been forced to respond in writing to the petition, after it passed an interim goal of 10,000 signatures last year. The statement which the department released in the autumn read: “there is a trade-off between pay and jobs in many public services, and pay restraint is one of the many difficult choices the Government has had to make.” It added that while pay restraint is challenging, overall earnings for nurses and other non-medical staff have increased 0.8-4% per year since 2010/11, due to low levels of inflation.

Royal College of Nursing (RCN) Chief Executive Janet Harding described the petition’s success as an “incredible achievement” and a “monumental step” in campaigning for better pay. “Nursing staff are going above and beyond every single day, yet they have endured the public sector pay cap since 2010”, she said, adding that more and more members are telling the RCN they are reaching breaking point. “We will continue to fight until all nursing staff receive the pay they truly deserve”, she said.

STPs forecast NHS will employ thousands fewer nurses

The NHS will deal with extreme funding pressure by employing thousands fewer nurses and other staff, according to unpublished proposals seen by HSJ this week. The findings are based on the finance, workforce and efficiency components of the sustainability and transformation plan process. 44 Sustainability and Transformation Plans (STPs) were submitted to the Department of Health last year, setting out how each NHS area or ‘footprint’ across England will implement the recommendations of the Five Year Forward View. The overarching STPs were published last autumn, but many of the more detailed annexes have been kept private, and it is some of these which HSJ has seen on the condition of anonymity.

11 of these STPs are reported to forecast a 1.6% reduction in whole time equivalent staff between 2016-17 and 2020-21, including a 2.3% reduction in registered nursing posts. Extrapolated across England, this projects reductions of 17,300 staff overall and 7,300 in the nursing, midwifery and health visitor group, which is dominated by nursing. NHS England’s chief executive Simon Stevens has distanced himself from the STP figures, stating last week: “It is certain that we are going to need more qualified nurses in the National Health Service in five years’ time than now.”

It could be that most of these cuts to nursing occur in hospitals and mental health, however, as the STPs also show that community and primary care are projected to see the fastest increases in funding, at the expense of slow growth in general acute and mental health spending. Total planned CCG spending across the 11 areas analysed shows a 25.9% increase in community health services spending; a 22% increase in core general practice and other primary care; and a 20.4% rise in spending on specialised services. This is represented in a wider theme across many of the STPs of moving care from acute to primary and community settings as a means of preventative demand reduction and saving money. By contrast, general acute services will receive a funding increase of just 2.4% and mental health an increase of 12.3%. NHS England’s response to the findings indicated that cuts in nursing could be mitigated by more registered nurses working in GP practices, but this detail is not included in the STPs.

School nurses launch online teen advice

School nurses from Hertfordshire Community Trust are to help run two new health websites for children and young people across the UK. The Health for Teens and Health for Kids websites feature content that promotes a “healthy body and mind”, and include information on both continence and local school nursing services. While the original concept and design of the websites are the work of Leicestershire Partnership NHS Trust – with which Hertford Community Trust is working in partnership – responsibility for updating the content will fall to Hertfordshire Community Trust’s nursing team.

Commenting on the new websites, Andrea Harrington, Hertfordshire Community Trust’s strategic lead and operational manager for school nursing, said: “These sites not only give children and young people helpful health and wellbeing guidance, but can be accessed by parents, carers and teachers to utilise the variety of resources available such as interactive games, signpost to other local health services or download relevant information materials”. She added that “people can also search for contact details of their child’s school nursing team”. Helen Thompson, Leicestershire Partnership’s director for family, young people and children’s services, said: “We are confident that, just as we have seen in Leicestershire, the websites will facilitate access to the expertise and support of Hertfordshire’s school nursing teams, to make a difference to children, young people and families locally”.

Weekly political news round up – 13th January 2017

January 20, 2017 in News by Whitehouse

Overview

This week, the escalating pressures on A&E departments during the post-Christmas period has featured heavily in the media, exacerbated by the Red Cross’ suggestion that it was having to support hospitals due to a “humanitarian crisis” in the NHS. Theresa May denied the claim during an interview with Sky News, and it has subsequently emerged that the Royal College of Emergency Medicine has begun “early discussions” with the Department of Health about a long-term investment and staffing plan to support A&E departments. The Government has stated there will not be any “further funding this year”, but did not comment on any potential future funding settlements. The Labour Party placed further pressure on the Government to address the current difficulties in the NHS during an Opposition Day debate in the House of Commons.

The Prime Minister has also hired her first health adviser since taking office, after being criticised for failing to prioritise the role during her first six months in power. Her new adviser, James Kent, trained as a doctor before moving into the private sector, and joins Number 10 from his role as a management consultant at Boston Consulting Group, where he specialised in “payers, providers, and health care systems.” He also focused on driving “BCG’s work on value-based health care and the implications of real-world outcomes on health care.” In addition to criticism for not hiring a dedicated health adviser, the Prime Minister has previously been under scrutiny for the concentration of power within her policy team held by her joint chiefs of staff, Fiona Hill and Nick Timothy.

Finally, the Prime Minister is now understood to have launched a review of the integration of health and social care policy before Christmas. This has entailed the secondment of civil servants such as the Department for Education’s director general for children’s services, Paul Kissak, to the Cabinet Office, and is intended to produce an internal report by March.

NHS Chief Executive encounters difficulties with Downing Street

Relations between NHS England’s Chief Executive Simon Stevens and Downing Street were strained this week, following continued public disagreement over the amount of funding given to the NHS following the Five Year Forward View. Theresa May told Sky News last weekend that the NHS had been given “more funding” than required, after ministers said that it had asked for £8 billion and been given £10 billion. In response, Stevens told the Public Accounts Committee on Wednesday that NHS England will indeed be getting an extra £10 billion over the course of six years, but that this is not the same as saying that the NHS will receive more than asked for over five years. “It was a five-year forward view, not a six-year forward view”, he said.

Stevens’ “political interventions” were reported to have irritated No 10 before he appeared in front of the Public Accounts Committee – following repeated comments on alternative to solutions to funding health and social care – with aides accusing him of being “insufficiently enthusiastic and responsive” to meeting the challenges currently facing the NHS. His latest comments have provoked reports that his position could be at risk if his interventions continue. The Telegraph cited a government source as suggesting that Stevens was doing a good job running the NHS, but would have to “calm down” to keep his job in the long-term.

Prime Minister unveils mental health plans

Theresa May has this week announced her intention to “transform” mental health support, in what was viewed by many as an attempt to underline that her Government is addressing issues beyond Brexit. Although not offering any additional funding, the Prime Minister said she would speed up the delivery of a £67 million package to improve digital access to mental health care and build on £15 million of investment to “provide and promote new models of community–based care such as crisis cafes and community clinics.”

The plans – which are set out in the Government’s response to the  Five Year Forward View for Mental Health – will focus on early intervention for children and young people. Notable measures will include:

  • Offering all secondary schools in the country mental health first aid training over three years;
  • Trials on strengthening links between schools and NHS specialist staff, including a Care Quality Commission-led review of children and adolescent services across the country;
  • A green paper on transforming services for children and young people at schools, universities and for families;
  • Support for NHS England’s commitment to eliminate out of area inpatient placements for children and young people; and
  • A ringfenced £15 million fund to expand community support for people with mental health problems including new crisis cafes and community clinics, building on the £15 million already used to create new places of safety.

Unveiling the plans in a speech on Monday, the Prime Minister said: “I want us to employ the power of government as a force for good to transform the way we deal with mental health problems right across society, and at every stage of life.” The Chairs of the Education and Health Committees, Neil Carmichael MP and Dr Sarah Wollaston MP, released a joint statement in response to the announcement, welcoming the focus on children’s mental health but warning that “if long-term improvements are to be achieved then schools and health services must be given the proper resources, support and expertise so they can work more closely and effectively together.”

Transcripts of NHS Sustainability Committee evidence sessions published

The House of Lords’ NHS Sustainability Committee has released the transcript of the evidence session that the Health Secretary Jeremy Hunt attended before Christmas, as part of the Committee’s inquiry into the long-term sustainability of the NHS. Mr Hunt addressed the issues of workforce planning and public health in his testimony, saying that the NHS needed to take a more strategic approach towards workforce planning, and that the UK will need to spend a greater proportion of its GDP on health and social care and recruit more doctors and nurses over the coming decades. He said that increasing the number of doctors and nurses is of vital importance, as putting money in without having the doctors and nurses there to deliver the extra care will cause inflation in the prices paid to the workforce – “which is very nice for them but is not necessarily what the taxpayer intended”. Strategic workforce planning is not a problem that can wait, he added, indicating that the time needed to train doctors requires that the Government act now.

Later in the session, when Baroness Featherstone argued there is a need to spend money on public health, and asked what assessment his department has made about its impact on public health, Hunt responded that he did not accept that a public health budget being cut automatically means that the Government is unable to make progress on big public health issues. “There are some efficiencies that can be made”, he said, “but there are some big things that you do in public health that happened under the last Labour Government, such as banning of smoking in public places, that have a huge impact on public health which are not about expenditure.”

Weekly political news round up – 6th January 2017

January 20, 2017 in News by Whitehouse

Overview

This week, the Chairs of the Communities and Local Government Committee, the Public Accounts Committee and the Health Committee have published a joint letter urging for a cross-party consensus to be established on the future of health and social care funding. They called for a cross-party review to be undertaken as soon as possible, adopting an integrated approach to the health and social care systems to overcome the avoidable barriers and inefficiencies that separation has created.
Elsewhere, an NHS Foundation Trust has been awarded a five-year contract to provide the new 0-19 public health community nursing service for families in West Sussex; the Royal College of General Practitioners (RCGP) has responded to an investigation by the British Medical Journal which revealed that CCGs in England are spending millions of pounds on schemes that screen patient referrals from GPs to specialist services; and Health Education England has announced plans to explore a new bridging role combining both nursing and therapy skills, once the new nursing associate role is established.

Select Committee Chairs call for cross-party consensus on health and social care funding

The Chairs of three House of Commons’ Select Committees – the Communities and Local Government Committee, the Public Accounts Committee and the Health Committee – have published a joint letter urging for a cross-party consensus to be established on the future of health and social care funding. The letter follows the Prime Minister’s appearance before the Liaison Committee before Christmas to discuss the issue, when she cast doubt on initial cross-party involvement on the basis that it had previously not been productive, but did not rule the option out.

The Chairs wrote that “each of our committees has examined the challenges of financial sustainability from its own perspective”, pointing out that the Health Committee has already concluded that the system is “at breaking point”, while the Communities and Local Government Committee and Public Accounts Committee are due to report on the issue by Spring.
They called for a cross-party review to be commenced as soon as possible, addressing social care challenges in particular, but also including the NHS. The review should cover the two systems, they said, as “the ongoing separation of health and social care is creating difficulties for individuals and avoidable barriers and inefficiencies”. They added that the necessity of this has been made clear from the backing of organisations including the King’s Fund, the Nuffield Trust and the Local Government Association; as well as by Simon Stevens, Chief Executive of NHS England, and Stephen Dorrell, Chair of the NHS Confederation.

Public health community nursing service contract awarded in Sussex

Sussex Community NHS Foundation Trust has been awarded a five-year contract to provide a new 0-19 public health community nursing service for families in West Sussex. The contract is the latest development in a move towards integrating services nationally, following the handover of public health commissioning responsibilities for children aged 0-5 from the NHS to local authorities in 2015. West Sussex County Council – which awarded the contract after a competitive procurement process – hopes it will create a more integrated service, bringing together health visiting, school nurses, and early help and prevention services into a single model.
Trust chief executive Siobhan Melia expressed delight at securing the new contract, saying: “We are committed to ensuring that families and young people experience an extensive range of excellent, localised, seamless support and we look forward to working with the council to make this a reality for people in West Sussex”. Christine Field, West Sussex County Council’s cabinet member for wellbeing, said: “We want our children, young people and their families to be healthy, happy, safe and ready for school and for life. Our vision is to have a joined-up service, which all residents can access near to home.”

RCGP calls for CCGs to spend their budgets on better support for local GPs

The Royal College of General Practitioners (RCGP) has called on CCGs to spend their budgets on improving support for local GPs, after an investigation by the British Medical Journal revealed that CCGs are spending millions of pounds on schemes that screen patient referrals from GPs to specialist services. RCGP Chair Professor Helen Stokes-Lampard recognised that the lack of funding for general practice is forcing CCGs to explore different methods of reducing costs, but said: “Before any decision is taken by a CCG to allocate some of its funding into schemes such as management referral systems – and paying private companies to run them – they need to be properly evaluated and assessed to see if they will be effective, safe and ultimately benefit the care provided to patients.”
“While not all of the CCGs disclosed information about their spending, it’s concerning to see that so few using these schemes have actually reported saving money” she said, adding that “it is absolutely vital that CCGs spend their budgets effectively given the limited resources in general practice; providing better support to local GPs to enable them to deliver high quality care to patients.” These comments followed another press release published earlier in the week, in which the RGCP warned that a seven-day service could not be achieved without “serious impact” on weekday service, as the number of GPs has not kept pace with demand.

King’s Fund identifies five NHS priorities for 2017

Health think-tank the King’s Fund has identified five areas the NHS should prioritise in 2017. It predicts that 2017 will be a challenging year, as under the Five Year Forward View the NHS must deliver £15 billion of efficiency improvements at a local level, and a further £7 billion at a national level, by 2020/21. The five priorities the King’s Fund sees as crucial to overcoming this challenge are:

1. New care models: Plans to integrate care should be accelerated, and more care should be delivered in people’s homes or closer to home, with greater investment in district nursing, general practice and social care.
2. Sustainability and Transformation Plans (STPs): STPs are the plans which NHS footprints (geographical areas) have put forward to transform the delivery of healthcare. Having focussed on planning in 2016, the challenge is now to begin implementation – a move which the King’s Fund says will require deeper engagement with stakeholders, and strengthening of leadership and staffing.
3. Delivering better value: The King’s Fund notes that the Carter Review identified several ways of improving productivity in the NHS. As funding increases have tailed off and deficits among NHS providers have risen, it argues that it is more urgent than ever for improvements to be delivered.
4. Strengthening Leadership: The King’s Fund argues that the success of STPs and new care models depends on experienced organisational leaders developing into system leaders who can work across boundaries to negotiate and implement improvements in care.
5. Securing adequate funding: According to the King’s Fund, the Government must choose between finding additional resources for health and care or being honest with the public about “the consequences of continuing austerity on the quality of care”. It is also argued that the Government must build on the work of the Barker Commission on social care, and initiate a debate about a new settlement for health and social care which goes beyond the short-term interventions that have sought to support the current system.

New ‘bridging’ role combining nursing and therapy skills

Health Education England has announced that a new bridging role combining both nursing and therapy skills could be introduced once the new nursing associate role is established. Under current plans, the first 2,000 nursing associates will begin training at 35 test sites across the country during 2017. They will complete a two-year programme, before going on to “bridge” the gap between healthcare assistants and nurses, as part of the Government’s plan for integration of services.
Health Education England chief executive Ian Cumming has now said that once the controversial new career path has become “business as usual”, the workforce planning body could then look at introducing therapy associates along similar lines. He said that employers had wanted a new “nurse therapist” post for a while, noting that while this could exist at the registered professional degree level, it could also exist at the associate level. He said: “I actually think the next stage we’ll be going [to], once it is business as usual for nursing associates, may be either therapy associates, or maybe taking it to be a more generic care/health”.

Weekly political news round up – 23rd December 2016

January 20, 2017 in News by Whitehouse

Overview

A new minister has also been appointed to the Department of Health this week: Lord O’Shaughnessy will replace Lord Prior as the Parliamentary Under Secretary of State for Health, and will assume ministerial responsibility for medicines, specialised commissioning, and reducing clinical variation. Lord O’Shaughnessy was David Cameron’s director of policy between May 2010 and October 2011, and was appointed as a peer in October 2015.

Elsewhere, the Treasury has announced that next year’s Spring Budget will take place on 8th March, which will be the last Budget to take place in the spring following changes announced in the Autumn Statement. Both House of Parliament have now entered recess for the Christmas period, and will both return on Monday 9th January.

Local Government Finance Settlement cuts public health funding

The Department for Communities and Local Government has this week published the provisional local government finance settlement, showing that councils will receive £84 million less for public health in government funding in 2017/18 than they did during this financial year. The local government finance settlement is determined on an annual basis, and the settlement announced this week marks the third time in as many years that funding has been cut, following a £77 million reduction in 2016/17 and a £200 million in-year cut in 2015/16. The Communities and Local Government Secretary Sajid Javid made the announcement in a statement to Parliament, with headlines dominated by the accompanying announcement of additional funding for social care.

Responding to the news, the Chairman of the Local Government Association’s Community Wellbeing Board, Izzi Seccombe, said: “Central government’s cutting of the public health budget is a short-term approach and we are concerned this decision could undermine the objectives we all share to improve the public’s health and to keep the pressure off adult social care and the NHS.” She pointed out that removing funding from the services which can be used to prevent illness and the need for treatment later down the line is extremely counterproductive. Local authorities were keen to take responsibility for public health in 2013, she added, but “many will now feel that they have been handed all of the responsibility but without the appropriate resources to do so.”

Government responds to Health Committee’s report on Public Health Post-2013

The Government has published its formal response to the Health Committee’s report on public health post-2013, stating that while it “fully appreciates” the need to protect and improve public health, it believes that local authorities (LAs) can do this through wider activities that “delivering a set of narrowly-defined services from a ring-fenced grant.” It said that LAs need to “address all the determinants of public health – a ‘place-based’ approach, that can bring together funding streams from local government, central government and the NHS.”

Of greatest relevance to the PCF was the Committee’s warning that barriers to workforce mobility have not been removed despite it being three years since public health responsibility was transferred to local authorities. The Government said that it will “continue to work with PHE and the LGA to monitor the impact on the public health workforce of the current arrangements”. The Health Committee also stated it would review progress on this in a further six months.

Government responds to Health Committee’s report on the impact of the Comprehensive Spending Review

The Government has formally responded to the Health Committee’s report on the impact of the 2015 Comprehensive Spending Review (CSR), which was published in July 2016. The Government says that the Committee “correctly identifies the significant challenges facing the NHS over the next few years”, and highlights that its own response to these challenges entails extra investment for the NHS; shoring up the NHS’s financial sustainability; reducing demands for acute care; and promoting efficiency and productivity in the provider sector.

On funding for public health, the Health Committee had expressed the view of many of its witnesses that public health cuts will be a “false economy”, and that monitoring public health spending is of great importance. The Government agreed that monitoring variations in public health outcomes is crucial, and will be achieved through the Public Health Outcomes Framework. The response did not mention public health responsibilities such as school nursing.

The response also specified that the challenge to find £22 billion of efficiency savings within the NHS over the course of this parliament will be delivered through £6.7 billion of “national action” and £14.9 billion of local savings. On the concerns raised about NHS workforce planning, the Government highlighted action taken by Health Education England and NHS England to “boost the supply of domestically trained staff and to increase the efficiency and productivity of the existing workforce through better use of technology and changing the skill mix.” It also defended the 1% public sector pay freeze implemented across the NHS, saying it “continues to be a crucial part of government plans for the continued prudent management of public finances”.

Scottish Government publishes Health and Social Care Delivery Plan

The Scottish Government has this week published its Health and Social Care Delivery Plan, which sets out a series of measures to speed up improvement and change within the devolved health and care system. It aims to provide care that is integrated; focused on prevention; and creates minimal risk of re-admission.

The report acknowledges that Scotland faces significant public health challenges in the years ahead, ranging from lifestyle behaviours to socio-cultural factors which prevent positive health choices. The report notes that there are many social determinants which impact on health and wellbeing, and makes special mention of Adverse Childhood Experiences. As such, there is a recognition that “we need to increase public and service knowledge and awareness of where avoidable harm can be reduced”, which includes a “wider understanding of both physical and mental health and the right actions to promote and strengthen healthy lifestyles.”

In order to address the public health needs that lie ahead, the report outlines a plan to create a clear set of national public health priorities; streamline the public health landscape; developed a sustained approach to key public health issues; and support a More Active Scotland.

Weekly political news round up – 16th December 2016

January 20, 2017 in News by Whitehouse

Questions answered on paediatric continence services in the House of Commons

Sir David Amess MP has received answers to two written questions tabled on paediatric continence. The first asked whether the Department for Health has considered auditing the effect of NHS England’s Excellence in Continence Care guidance on the quality of paediatric continence services. In response, Health Minister David Mowat said the Department had undertaken no formal discussions with NHS England on auditing the effect of Excellence in Continence Care on the quality of paediatric continence services.

The second question asked how the Department plans to promote the commissioning of integrated paediatric continence services as a means of preventative healthcare, in line with the aims of the Five Year Forward View.

Mowat said that NHS England promotes its guidance through engagement with key stakeholders. He added that the Department of Health, together with the Department for Education, has published links to the Paediatric Continence Commissioning Guide as part of its support for commissioners, providers and health professionals implementing the new system for Special Educational Need and Disability. The Minister specifically referenced the PCF’s leading role in developing the Commissioning Guide and the fact that it “puts integration at its heart.”

Government launches £2.5 million fund to boost community-led services

The Department for Communities and Local Government has this week launched a £2.5 million fund to help local people who are “struggling to manage” and whose local services are not necessarily commissioned to meet their needs .The new Communities Fund will be allocated depending on local pressures, and is intended to help those facing domestic abuse, provide support for disabled children’s services, or to support those facing long-term unemployment. Funding will be given to proposals who can demonstrate how they “will become self-sustaining and avoid over reliance on grant funding in the future”, with a “mixture of financial support and advice” promised between now and April 2018.

The Communities Minister Andrew Percy noted that community groups are best placed to understand the challenges in their local neighbourhoods and reach those who need help. He said: “This new multi-million pound fund will go direct to those groups of people who are struggling to manage, including those facing domestic abuse or long-term unemployment”.

Health Secretary and Health Committee Chair give evidence to Lords’ Committee on NHS Sustainability

The House of Lords’ NHS Sustainability Committee met this week to hear evidence from, among others, the Health Secretary Jeremy Hunt and Chair of the Health Select Committee, Dr Sarah Wollaston. Addressing the issue of long-term funding, the Health Secretary said we will “have to find a way of devoting a greater share of our national resources in to health and social care. Without a doubt.” However, while he professed support for the continuation of a “taxpayer funded” health system, he said that in the long term he favoured models to encourage individual saving and insurance. Mr Hunt suggested that saving for social care provision in old age should be viewed in the same light as a pension, and “we need to make sure there is a proper safety net there for people who haven’t been able to do that.”

Meanwhile, Dr Sarah Wollaston also spoke of the need for greater funding, but did not share Mr Hunt’s stance on individual savings and insurance. She said: “I personally think that we should use a mechanism, a public mechanism… either [raising income tax] or through national insurance.” She added that while “you need to have a mechanism to bring more money into the system as a whole”, it is not for her to say what the right mechanism is. Instead, “there needs to be a cross-party consensus about how we achieve that in the long term.” The session built on Dr Wollaston’s recent criticism of the Government’s decisions around healthcare spending, having questioned its claim that it had allocated an additional £10 billion to the NHS by the end of this Parliament.

Survey finds nurses in Wales face “clear challenges” around levels of staffing and resources

The 2016 NHS staff survey for Wales 48% of staff say they cannot meet the conflicting demands on their time, and 49% disagree with the statement that there are enough staff for them to do their job properly. The score for conflicting demands shows no change since 2013 – when the last such survey took place – but reveal an improvement from the 55% who disagreed that there are enough staff for them to do their job properly in 2013. Elsewhere, 26% disagreed when asked whether they had “adequate materials, supplies and equipment” to do their job, representing an improvement on 39% in 2013.

Regarding senior management, 80% of staff say that their line manager treats them with respect – up from 75% in 2013 – and 61% of staff say that senior managers are committed to patient care – up from 49%. However, just 29% said that communication between senior managers and staff is effective, while 28% of staff say that senior managers will act on the results of this survey. In addition, while levels of work related stress have improved slightly, they are still high – 28% of staff say that they have been injured or felt unwell because of work-related stress during the past 12 months. Responding to the statistics, the Royal College of Nursing said the results demonstrated “that there are still some challenges, specifically around resources.” The overall trend is nevertheless one of improvement, as 61% of staff said they would recommend their organisation as a place to work, compared to 48% in 2013.