Weekly political news round up – 28th July 2017

July 28, 2017 in News by Whitehouse

Overview

Following reports last week that the Chancellor had proposed a transitional deal after Brexit, he has now suggested that such a deal would have to end by June 2022, before the next general election. The Chancellor is looking to ensure there is “business as usual” in the immediate aftermath of Brexit to provide confidence to businesses, and emphasised that it would be “some time before we are able to introduce full migration controls between the UK and the European Union” as new IT infrastructure will need to be implemented.

Statistics reveal 16% increase in nursing and midwifery vacancies

Statistics published by NHS Digital have demonstrated a 16% increase in the number of vacancies advertised for nursing and midwifery positions between March 2016 and March 2017, prompting further concerns for the professions. The data was accompanied by separate statistics showing the number of full time equivalent nursing and health visitor staff fell by 1,274 between March and April 2017, which the Royal College of Nursing (RCN) branded “a double whammy of bad news for nursing.” The RCN’s analysis also indicated that the number of nurses with more than ten years’ experience who are leaving the profession each year has doubled from 300 in 2013/14 to 600 last year.

The chief executive of the RCN, Janet Davies, commented that “A lethal cocktail of factors is resulting in too few nurses and patient care is suffering. The Government desperately needs to keep the experienced staff still working in the NHS.” The RCN is continuing its Summer of Protest against the public sector pay cap, planning a rally in central London and a drop-in event in Parliament, both on 6th September.

Scottish Government publishes evaluation of early adopter sites for Refocused School Nurse Programme

The Scottish Government has published an evaluation of the early adoption of the refined role for school nurses. Dumfries and Galloway NHS Boards and Tayside NHS Board adopted the new role, which required school nurses and the wider school health teams to focus on nine priority areas and work within a new referral system, in September 2015. These Health Boards’ school nurses focused on mental health, substance misuse, child protection, domestic abuse, Looked After Children, homeless children and families, children involved in the Youth Justice System, young carers and transition points.

The evaluation found that focusing on these priority areas “undoubtedly made the school nurse role more focused and standardised”, but there was controversy among professionals about which areas were included and excluded. The referral system allowing children to be referred through a pupil support teacher was also praised as ensuring that school nurses “receive mainly relevant referrals”, but also criticised for providing a barrier to accessing nurses in some instances. School nurses also reported that “it was generally recognised that they are now less accessible to the wider school population.”

Going forward, other Scottish Health Boards will be encouraged to adopt these new ways of working but “develop their own pathways as referral mechanisms and resources differ locally.” It is thought that staff will receive training for this new way of working over the next five years.

Former health minister warns of GP shortages

The former health minister and Labour MP Ben Bradshaw has suggested that the Government is “in denial” about the realities of GP workforce shortages. Bradshaw, who was a health minister under Gordon Brown and has recently been re-elected to sit on the Health Select Committee, highlighted that the Government’s plans to place GPs in A&E departments will exacerbate recruitment issues when coupled with existing shortages. He stated that the Government “is even now admitting it will have to try to attract thousands of new GPs from other EU countries, to fill the shortfall, which will be impossible under the hard Brexit being pursued by Mrs May.”

The Government allocated £100 million to fund A&E streaming in the Spring Budget following concerns about the performance of A&E departments during winter. The model is based on a streaming system implemented at Luton and Dunstable University Hospital, which is said to employ two to three GPs to staff the system each day. It has been suggested that if rolled out nationally this would require between 278 and 417 GPs to work in A&E departments every day.

Weekly political news round up – 21st July 2017

July 24, 2017 in News by Whitehouse

Overview

This week, Labour has announced it will focus on child health over the coming year against the backdrop of staff shortages in the paediatric workforce. The Department of Health has released its annual accounts, demonstrating marginal improvements to its financial performance from the previous year; and the schools budget in England has been increased by £1.3 billion over two years. The Government has also confirmed how it will allocate £325 million of capital funding for STPs that was first announced in the Spring Budget.

Labour announces focus on child health

The shadow health secretary Jonathan Ashworth has made a speech to the Royal College of Paediatrics and Child Health this week, outlining Labour’s intention to focus on child health over the coming year. Ashworth used the speech to highlight the decline in the number of school nurses and health visitors over the last two years, equating to a 10% reduction in the number of school nurses, an 11% reduction to health visitors and 12% to district nurses, and the impact this has had on child health. He also discussed figures from the RCPCH demonstrating that one in five paediatric trainee positions in the NHS is currently vacant, despite trainees being enthusiastic about entering the specialty.

Ashworth also said that the Labour shadow health team will convene a series of workshops over the next year to “draw together the evidence and expertise in the field of child health.” Commenting on the falling numbers of school nurses and health visitors, the professional lead for children and young people’s nursing at the RCN, Fiona Smith, highlighted that these professionals “are often the first point of contact for families and children experiencing mental and physical health issues, and their role is key in promoting healthy lifestyles.”

Department of Health annual accounts released

The Department of Health has published its annual report and accounts for 2016/17, reporting a 0.5% underspend to its £117.6 billion revenue budget, equating to £563 million. The underspend would not have been possible without the transfer of £1.2 billion of capital funding to the revenue budget, which had previously been agreed and would prevent investment in NHS infrastructure and estates. However, as the Department overspent by £200 million last year, the Government stated that it showed “good progress” in “challenging circumstances”.

The National Audit Office criticised the transfer of funds from the capital budget, stating that this will “have implications for the resilience of the service” if it prevents the NHS from investing in infrastructure. Similar transfers are currently scheduled to take place until 2020. The accounts also revealed that spending on healthcare provided by non-NHS bodies increased by 4.8% from the previous year, or £630 million, compared with a 2.3% increase (worth £175 million) to the amount spent on GP contracts.

Schools budget increased by £1.3 billion over two years

The Government has announced it will redistribute £1.3 billion of schools funding over the next two years to give all schools at least a 0.5% increase to their budgets in cash terms. When coupled with an additional £1 billion pledged by the Conservatives in their election manifesto and existing planned increase, the overall core schools budget is expected to rise by £2.6 billion between 2017/18 and 2019/20. However, the allocation has been criticised as it has been funded by reductions to other areas of the education budget – including the free schools budget and ‘healthy pupils’ projects – meaning there is no new funding from the Treasury.

The announcement has encountered a mixed reaction: while the leader of the ASCL head teachers’ union Geoff Barton said the allocation signified a “step in the right direction”, the consequences for other areas of the education budget were yet to be seen. Campaigners also highlighted the need for continued funding increases to compensate for rising pupil numbers and other increased costs, such as pensions and staffing.

Government allocates £325 million in capital funding to STPs

The Government has outlined how it will allocate £325 million of capital funding for Sustainability and Transformation Partnerships (STPs) that was first announced in the Spring Budget. The funds will be allocated to 15 STPs which are deemed “the strongest and most advanced schemes in the STP categories based on an assessment of leadership and service performance”, with the criteria being used to determine this published on Friday.

The money was allocated to enable STPs to implement significant innovations, especially if they move care away from acute settings into the community. Four STPs will receive funding for primary care or integrated care hubs, while other STPs will receive allocations predominantly intended for emergency care, such as Dorset which will gain at least £100 million for emergency and planned care services. The announcement reiterated that further capital funding can be expected in the Autumn Statement “and beyond”, but the Chair of the BMA’s GP Committee Dr Richard Vautrey added that the areas need recurrent funding rather than one-off allocations for the innovations to be financially sustainable.

Weekly political news round up – 14th July 2017

July 24, 2017 in News by Whitehouse

Overview

This week, the Welsh Government has published an interim report on its Review of Health and Social Care in Wales, highlighting the need for significant transformation to health and social care services. The Chairs of Select Committees in the House of Commons have been elected, and the House of Lords has held a debate on the public sector pay cap. NICE has published minor changes to its guideline on constipation in children and young people, and the King’s Fund has warned in analysis of public health budgets that services now face real-terms cuts.

Welsh Government publishes interim report on Review of Health and Social Care

The Welsh Government has published an interim report for its Parliamentary Review of Health and Social Care in Wales, with initial conclusions stating that health and social care services “have to change” through the implementation of new models of care. The report recommends that Welsh people, staff, service users and carers should have “greater influence on new models of care with clearer, shared roles and responsibilities”, while new skills and career paths should be developed for health and social care workers, and technology and infrastructure used in a higher quality and more efficient manner.

The report recognises that while steps could be taken now to increase primary and community care funding and grow the number of GPs, “these are not likely to be sustainable, and additional measures will be required to close the gap between need and capacity.” Although focusing on care for older patients and those with comorbidities, the report advocates for “expanded roles for other professional care groups” and “better care co-ordination and integration for people with multiple health and social care needs.” It also described community services as “the poor relation of other services”. Responding to the report, the Royal College of GPs Wales said that “Building on the existing strengths of general practice and developing new models of care will allow our healthcare services to adapt”, and expressed its willingness to work with the Welsh Government on the review over the coming months.

House of Commons’ Select Committee Chairs elected

Elections for Select Committee Chairs have taken place in the House of Commons this week, with Robert Halfon succeeding in being elected chair of the Education Select Committee. Halfon was the Minister of State for Apprenticeships and Skills until Theresa May’s reshuffle in June, and was competing against Nick Boles, Rehman Christi, Tim Loughton, Stephen Metcalfe and Dan Poulter for the position. He is widely respected in the further education community, which his work as a minister focused on, and many stakeholders were disappointed when he was sacked as a minister.

As confirmed last week, Sarah Wollaston was re-elected unopposed as Chair of the Health Select Committee, while Meg Hillier was returned as Chair of the Public Accounts Committee. The selection of members of committees was not expected to be completed before the autumn, although it has been reported that Labour members of the Treasury Committee have been chosen already.

House of Lords debates public sector pay cap

Members of the House of Lords have debated the possibility of a review of the public sector pay cap in the wake of a letter asking the Prime Minister to re-evaluate it in light of growing public concern. The debate was initiated by the Labour peer Lord Haskell, who said that the public feels “awkward” and “hypocritical” when realising that “because of pay restraint, [the earnings of public sector workers] have effectively decreased in recent years”. Lord Haskell also referenced the contradictory positions within the Cabinet on pay restraint, with the Chancellor “taking a firmer, more rigid view” on maintaining the policy.

The debate was preceded by a letter to the Prime Minister from peers protesting the continuation of the cap, saying that “Even though health care professionals deliver care to the best of their ability, patient care and safety is inevitably compromised when hospitals and other care settings are short of staff.” The chief executive of the RCN, Janet Davies, labelled the pay cap “unsustainable” and highlighted the growing group of parliamentarians supporting its removal – she also met with the SNP’s Westminster Health spokesperson Dr Philippa Whitford this week to discuss the issue.

NICE publishes minor changes to guideline on constipation in children and young people

NICE has marginally changed its guideline on constipation in children and young people: diagnosis and management, following its consultation on the guideline in June. The changes were to update two footnotes in the guideline to include a new NICE guideline on coeliac disease and altered manufacturer information.

However, beyond this, NICE has decided that no new evidence had been presented that affects the recommendations in the guideline, and so would not update the guideline at this point. The publication of the update stated that evidence on transanal irrigation was identified by the review, but was “considered to be insufficient in volume and conclusive results to add new recommendations at this time.”

King’s Fund publishes analysis of public health budgets

The King’s Fund has published analysis of local authorities’ public health budgets for 2017/18, drawing comparisons with budgets since 2013/14. Taking into consideration the transfer of children’s 0-5 services to public health budgets and inflation, public health spending was £2.52 billion in 2016/17 against £2.51 billion in 2013/14, which equates to 5% less funding in real terms over this period. The analysis concludes “there is little doubt that we are now entering the realms of real reductions in public health services. This is a direct result of the reduced priority that central government gives to public health.”

The report particularly expressed concerns at the reductions in sexual health, smoking cessation and drug treatment services, which the author David Buck warned is “the falsest of false economies.” The Local Government Association said that “Local authorities were eager to pick up the mantle of public health four years ago, but many will now feel that they have been handed all of the responsibility, but without the appropriate resources to do so.”

Weekly political news round up – 7th July 2017

July 24, 2017 in News by Whitehouse

Overview

It has been confirmed that Sarah Wollaston has been re-elected unopposed as Chair of the Health Select Committee, and Meg Hillier as Chair of the Public Accounts Committee. The Education Select Committee has had six nominations for its Chair: Nick Boles; Rehman Christi; Robert Halfon; Tim Loughton; Stephen Metcalfe; and Dan Poulter. MPs will vote for the Chairs of each Committee being contested on Wednesday 12th July, with the results being announced at the end of that day.

Education ministerial portfolios confirmed

The Department for Education has confirmed that Robert Goodwill’s has been appointed as Minister of State for Children and Families, with responsibility for early years policy, special educational needs and disabilities and child protection. Nick Gibb, the Minister of State for School Standards, has had his portfolio expanded to include personal, social, health and economic education, relationships and sex education and children and young people’s mental health. These aspects were previously the responsibility of Caroline Dinenage, whose portfolio has been redistributed.

It has also been reported that since being reappointed, the Education Secretary Justine Greening has been pressuring the Government to swiftly allocate schools an additional £1.2 billion in funding. The Conservative manifesto had pledged to increase the overall schools budget by £4 billion by 2022, but this would represent a real-terms 2.8% reduction in funding per pupil, leading Greening to pressure for more funding to be promised before the summer holidays.

Ministers attend first Health Questions of new Parliament

Ministers have attended the first session of Health Questions of the new Parliament, with Steve Brine and Jackie Doyle-Price debuting as part of the Government’s health team. During the session the Government re-committed itself to the target of recruiting an additional 5,000 GPs by 2020, despite not including it in their election manifesto. The primary care minister said that increasing GP numbers “is an essential part of creating a strong and sustainable general practice, and indeed NHS, for the future.”

The session also featured questions on the progress of STPs and how the Department of Health becomes involved with individual CCGs’ decision-making processes to improve healthcare provision. In response to a question on this and deadlock between CCGs from the Conservative MP Daniel Kawczynski, Brine did not indicate that the department would intervene in such stalemates, suggesting that local decision making would be left to prevail wherever possible.

Labour conducts minor reshuffle

Labour has conducted a minor reshuffle of its shadow frontbench, appointing 20 MPs to positions including former shadow ministers Louise Haigh, Rachael Maskell and Gloria de Piero, who have been appointed to the Home Affairs, Transport and Justice teams respectively. Some of the MPs appointed were newly elected or re-elected MPs such as Chris Williamson, Tony Lloyd and Anneliese Dodds, with Lloyd becoming a shadow housing minister and Dodds joining the shadow Treasury team. While appointments were made across a range of departments, only a few specific portfolios were confirmed, primarily in the shadow home affairs team.

LGA Chairman highlights 75% of core government funding for councils cut by 2020

The Chairman of the Local Government Association, Lord Porter, has said to the association’s annual conference that councils should be first in line for new funding if “austerity is coming to an end”, underlining that local authorities will have lost 75% of their central government funding by 2020. Lord Porter stated that by 2020, nearly half of all local authorities will not receive any central government funding but will still be left with an overall funding gap of £5.8 billion. He explained that it is nearly impossible to meet this funding gap, as “even if councils stopped filling in potholes, maintaining parks and open spaces, closed all children’s centres, libraries, museums, leisure centres, turned off every street light and shut all discretionary bus routes they still would not have saved enough money to plug this gap by the end of the decade.”

Lord Porter said that “Councils can no longer be expected to run our vital local services on a shoestring”, and called for local authorities to be able to keep all revenue collected from business rates – £26 billion a year – and be able to hold referendums on increasing council tax without centrally imposed limits.

17 NHS staff unions issue pay restraint warning

17 NHS staff unions, including the Royal College of Nursing, the British Medical Association, GMB and Unite, have joined forces calling for the Government to end the public sector pay cap to prevent “lasting damage to the NHS workforce and the patients they care for.” The Royal College of Nursing warned that the pay cap is impacting the NHS’s ability to recruit more nurses, citing figures published by the Nursing and Midwifery Council the previous day showing that more nurses are now leaving the NHS than joining. Unison’s head of health, Sara Gorton, said “Not only do staffing shortages affect care quality and safety, they put pressure on the remaining nurses, healthcare assistants and midwives as well.”

The warning came in the same week that Sarah Wollaston also commented on the NHS pay cap, warning that perpetuating it would have consequences for “recruitment, retention and morale”, as well as patient safety. In an interview with Parliament’s House magazine, Wollaston also notably called for a figure such as Norman Lamb to be appointed to chair a cross-party commission on health and social care spending, choosing Lamb particularly as the figure would need to be “somebody who is respected across the House, who we know works in a good consensual manner to chair this and get it going.”

Weekly political news round up – 30th June 2017

July 24, 2017 in News by Whitehouse

Overview

The Government has published a policy paper containing proposals on how EU citizens living in the UK will be able to remain in the country after Brexit, with suggestions that an online application process will give applications “indefinite leave to remain”. The EU was sceptical in its response to the proposals, with the bloc’s chief Brexit negotiator Michel Barnier saying that “more ambition, clarity and guarantees needed than in today’s UK position.” The Royal College of Paediatrics and Child Health noted the number of EU nationals working in child health within the NHS, and said that “a simple assurance that their right to work in the UK will be protected, and their conditions secured, would be immeasurably helpful.”

DUP agree deal to support Conservatives in government

The Democratic Unionist Party (DUP) have come to an agreement with the Conservatives to support the Government in key House of Commons votes, enabling the Conservatives to form a minority government. The conditions of the deal state that the DUP:

  • Has agreed to support the Government in votes of confidence, the Queen’s Speech, the Budget and other financial matters.
  • Will support the Government on Brexit legislation and legislation concerning national security, but that all other issues will be considered on a case-by-case basis.

In exchange, the Conservatives have agreed to:

  • Preserve Winter Fuel Payments and the pensions ‘triple lock’ – a change to the Conservative manifesto.
  • Recognise the importance of agriculture in Northern Ireland – particularly in the context of Brexit negotiations – and sustain subsidies to farmers until the next general election.
  • Provide Northern Ireland with £1 billion of additional funding to spend on infrastructure, health and education over the next two years.

Speaking outside Downing Street, DUP leader Arlene Foster said the agreement would “operate to deliver a stable government in the United Kingdom’s national interest at this vital time”. On the additional spending, she praised the Conservatives for having “recognised the case for higher funding in Northern Ireland, given our unique history and indeed circumstances over recent decades.” Mrs May stated that the deal was “very good one” for Britain, and that the Conservatives and the DUP “share many values in terms of wanting to see prosperity across the UK”.

Labour leader Jeremy Corbyn has said that the deal is “not in the national interest”, and has demanded that “cuts to vital public services must be halted right across the UK, not just in Northern Ireland”. The agreement is designed to remain in place for the duration of the parliament, but will be reviewed at the end of each parliamentary session. Given that there will be no Queen’s Speech in 2018, the first review will likely be in spring 2019. With the support of the DUP, this agreement gives the Conservatives an effective majority of 13 in the House of Commons.

Vote on public sector pay cap defeated in House of Commons

Pressure has grown this week for the Government to end the 1% pay cap for public sector workers, culminating in a vote on an amendment to the Queen’s Speech tabled by Labour being defeated. Cabinet Ministers included the Defence Secretary Sir Michael Fallon and the Transport Secretary Chris Grayling spoke of the need to ease the cap in the media in the days before the vote, leading to contradictory briefings from Downing Street which eventually confirmed that the Government’s position on the pay cap “has not changed.” The Chancellor had also said after the election that the Government is “not deaf” to public discontent with the pay cap.

The rejection of the amendment was received negatively by the Royal College of Nursing, with Chief Executive Janet Davies calling it a “a bitter disappointment for nurses and others in the public sector.” The RCN said that while its planned Summer of Protest against the cap would continue, it would look to “continue to build cross-party support this summer. If the Prime Minister intends to address pay in an autumn Budget, she should do so without delay.”

Welsh Government publishes proposals on quality and governance in health and care

The Welsh Government has published a White Paper proposing “more integrated ways of working and better decision-making” in health and social care services in Wales, which will now be consulted on. ‘Services fit for the future’ focuses on strengthening the leadership of Welsh Health Boards “to promote stronger governance and leadership to ensure services are led, planned and developed in the way they need to be in the years to come.” It also proposes replacing Community Health Councils, which allow the public to be involved in healthcare decisions, with “new independent arrangements which would represent the interests of citizens”; and introducing a mechanism for these new citizens bodies to “provide clinical advice on substantial service change decisions”.

The language of the document reflects that of breaking down organisational barriers which is becoming more common in the NHS in England: the Health Secretary Vaughan Gething said the changes will “enable health and social care organisations to work together and across boundaries to ensure they deliver the very best care.” The Welsh Government will merge the proposals with the outcome of the Parliamentary Review of Health and Social Care in Wales.

CYPNAUK publishes position paper on education of children’s nurses

Children and Young People’s Nursing Academics UK (CYPNAUK) has published a position paper on the future of children’s nursing and the education of children’s nurses, in light of the Nursing and Midwifery Council’s consultation on its pre-registration nursing education standards. The paper outlines the increasingly complex nature of children’s nursing and the growing consciousness and engagement of children, young people and their families in decisions affecting their health and care. As such, the organisation states that “children’s nursing should not be considered a ‘specialism’ but rather as generic care relating to the specific age periods of childhood and adolescence”, requiring extensive preparation and training for working with children.

The paper also points to statistics suggesting there is a “46.9% gap for children’s nurses in community settings”, meaning that many newly qualified children’s nurses choose to work in institutional settings rather than in the community. CYPNAUK ultimately calls for dedicated children’s nursing training “which itself includes integral fields of highly specialist practice” to be maintained, rather than children’s nursing becoming absorbed into generalist nursing qualifications.

Weekly political news round up – 23rd June 2017

July 24, 2017 in News by Whitehouse

Overview

This week, the Government proposed its legislative programme in the Queen’s Speech, and details of the expected ministerial portfolios for the two new health ministers have emerged. The former children’s minister, Tim Loughton, has also called for a focus on children and young people’s issues, stating that the lack of this during the election campaign was a “concern”.

Government proposes legislative programme in Queen’s Speech

The State Opening of Parliament has taken place this week, including the Queen’s Speech setting out the Government’s legislative agenda for the coming two years. The leader of the House of Commons, Andrea Leadsom, had previously announced that this parliamentary session will be extended from one to two years to enable Parliament to scrutinise legislation relating to Brexit – as such, the next Queen’s Speech will not be until 2019.

Eight of the 27 Bills announced in the speech pertained to Brexit, including the Repeal Bill to reverse the European Communities Act; an Immigration Bill; a Nuclear Safeguards Bill; and an Agriculture Bill. As expected, many elements of the Conservative manifesto which would have been included in the speech had the party achieved a majority were dropped, such as plans to means-test winter fuel payments for pensioners and scrap free school meals for all infant school students.

There was no legislation announced of major relevance to the PCF. On healthcare, there will be a draft Patient Safety Bill, which will aim to improve how the NHS investigates and learns from mistakes by establishing an independent Health Service Safety Investigation Body, and to encourage staff to share information with this body. There will also be reform of mental health legislation.

On education, the Government will not take forward its plan to repeal the ban on new grammar schools, with selective education not being mentioned at all in the document. The Government has expressed its intention to still pursue its “manifesto commitment to make [school] funding fairer”, despite the high levels of criticism received by schools which were set to lose funding under the new formula. It is thought that the formula will be revised to ensure that no school loses out from its existing funding arrangements, but schools which have historically been underfunded will have their funding increase.

Following the backlash against the Conservatives’ social care proposals during the election campaign, the Government has rowed back from legislating on social care funding in the immediate future. The speech did announce the Government will bring forward proposals for public consultation on the long-term future of social care – seemingly focused on the quality of care as well as long-term finances – and consult on these.

Responding to the Queen’s Speech, the Royal College of Physicians’ president Professor Jane Dacre expressed her concern that the Government had not addressed healthcare issues such as regulating new health professionals, and reiterated her previous statement that “the process of exiting the EU cannot be allowed to risk patient safety or the quality of care.” The Royal College of Nursing criticised the Government’s failure to lift the public sector pay cap, following significant focus on it from other parties during the election campaign.

Health ministerial portfolios emerge

Of the two health ministers appointed last week, Jackie Doyle-Price is due to be appointed as Minister for Care and Mental Health and Steve Brine is due to become Minister for Public Health and Primary Care. Doyle-Price’s portfolio is thought to cover care for vulnerable people; social care; community care; and women and children’s health, including school nursing and health visitors. Brine would have responsibility for issues including NHS transformation, including new models of care and STPs; primary care; and the public health system, along with oversight of Public Health England.

Doyle-Price’s appointment to this portfolio may have been influenced by comments she previously made about GP shortages which could be construed as critical of the profession, and would have made her appointment to the portfolio covering GPs difficult. Meanwhile, the portfolios for the two new ministers at the Department for Education – Anne Milton and Robert Goodwill – have yet to be confirmed.

Former minister calls for focus on children and young people’s issues

The former children’s minister Tim Loughton has labelled the lack of focus on improving services for children and young people from the Government “concerning” in an interview with CYP Now. Loughton, who was children’s minister between 2010 and 2012, said “It was a shame children and young people’s issues didn’t play such a prominent part in the campaign”, with previous agendas for reform such as his Positive for Youth policy statement being ignored.

Loughton also highlighted the impact of three ministers with briefs relating to children and young people losing their seats at the election – namely the children’s minister Edward Timpson, youth minister Rob Wilson, and public health minister Nicola Blackwood. Having to replace these ministers is “a slight concern”. Loughton did acknowledge the Government’s plans on children and young people’s mental health, but said that Brexit would provide a distraction, preventing other issues from coming onto the agenda over the next couple of years.

Weekly political news round up – 16th June 2017

July 24, 2017 in News by Whitehouse

Overview

The week’s political news has been dominated by the devastating fire in Grenfell Tower on Tuesday night and the Conservative Party’s attempts to form a governing agreement with the Democratic Unionist Party. Theresa May has had a difficult week in the aftermath of the election and the fire, compounded by a YouGov poll which shows she is now much less popular than Jeremy Corbyn, and nearly as unpopular as the Labour leader was prior to the announcement of a snap election in mid-April. The public’s view of Corbyn has moved in the opposite direction, with his popularity rising sharply throughout the election campaign.

Reshuffle confirms new ministers for Health and Education

This week’s Government reshuffle has seen the appointment of two new ministers in the Department of Health and two new ministers in the Department for Education. Jackie Doyle-Price and Steve Brine have been appointed to serve under Jeremy Hunt at DH after Nicola Blackwood, the former Minister for Public Health, lost her seat in Oxford and Abingdon and David Mowat, the former Minister for primary and social care, lost out in Warrington South last week.

Jackie Doyle-Price secured the ultra-marginal seat of Thurrock last week for a third-term, by a very small majority of 255 votes. Since entering parliament in 2010, Doyle-Price has sat on the influential Public Accounts Committee to scrutinise government spending and voted along party lines on NHS issues. During this year’s election campaign, she endorsed the sale of Orsett Hospital within her constituency at a hustings event, and has recently criticised local GPs in Thurrock for not “delivering enough to meet demand”. Doyle-Price voted in favour of a relaxation of the smoking ban, and was opposed to plain packaging. Steve Brine has previously worked as Jeremy Hunt’s Parliamentary Private Secretary and has actively campaigned on local NHS issues in his constituency of Winchester and Chandler’s Ford. Brine has argued for modernised acute care and parity of esteem for mental health, engaging frequently with trusts and the STP team in Hampshire. It has not yet been announced which will take the Public Health Minister portfolio.

Anne Milton and Robert Goodwill have been appointed as ministers in the Department for Education in the Government’s reshuffle. One of the two will have to replace the popular former Minister for Children and Families, Edward Timpson, who surprisingly lost his seat in Crewe and Nantwich to Labour. A vacancy also opened in the Apprenticeship and Skills post following the unexpected sacking of Robert Halfon. Robert Goodwill is a Eurosceptic from the right of the Conservative Party, and has served the Scarborough and Whitby constituency since 2005. Anne Milton has also been in Parliament since 2005, though is considered to be among the more moderate MPs on the Conservative benches. She has significant ministerial experience, serving as the Public Health Minister between 2010 and 2012. The exact portfolios are still to be confirmed.

DUP talks delay Queen’s speech

The Conservatives are yet to reach a formal agreement with the Democratic Unionist Party over a confidence and supply arrangement after a week of negotiations between the two parties. The Government is expected to conclude talks with a relatively loose agreement with the DUP that ensures it can pass an annual budget and survive key votes in the House of Commons. The talks are said to be stalling due to disagreements over funding for Northern Ireland, according to The Times, which reported on Wednesday that the Prime Minister is facing a battle with the Treasury over “bribes” it wishes to offer to Northern Ireland that may help to secure a deal. Downing Street figures want to give funds directly to the Devolved Government in Belfast as part of the agreement, but the Treasury has warned that higher spending needs to go through the Barnett Formula, which would lead to a requirement for additional funding in Scotland, England and Wales.

Theresa May has set Wednesday 21st June for the Queen’s Speech despite not currently having assurances that the DUP will vote for it. The speech has already been delayed for a few days due to the protracted talks with Unionist leaders, but the Government appears confident their potential partners in Northern Ireland will not prevent the speech from passing in the Commons even if a deal has not been reached beforehand. Senior Conservative sources have said there is “broad agreement” on the nature of an agreement, but also admitted there are differences between the Prime Minister and Chancellor over prospects for the UK staying in the EU Customs Union. Membership of the Customs Union had reportedly been favoured by the DUP before talks with the Conservatives began, but one source has told The Times that the Party now agrees with Theresa May that the UK should withdraw.

NMC releases consultations on nurse proficiency and medicines management

The Nursing and Midwifery Council has released consultations on Prescribing and Standards for Medicines Management and standards of proficiency for registered nurses.

The consultation on standards of proficiency for registered nurses sets out the minimum standards that a nurse will need to meet to be considered capable of safe and effective practice. Annex B of the consultation on Nursing Procedures explicitly references continence care, setting out eight key interventions or treatments to manage “needs for care and support”. These set out the requirement to:

  • observe and assess level of urinary and bowel continence to determine the need for support,
    intervention, level of independence and the level of independence and self-management of
    care that an individual can potentially have;
  • assist with toileting, maintaining dignity and privacy and managing the use of appropriate aids
    including pans, bottles and commodes;
  • select and use appropriate continence products including pads, sheaths and appliances;
  • insert, manage and remove catheters for all genders and assist with self-catheterisation when
    required *AH,*CH;
  • manage bladder drainage;
  • assess elimination patterns to identify constipation, diarrhoea and urinary and faecal retention;
  • administer enemas, suppositories and undertake rectal examination and manual evacuation
    when appropriate; and
  • undertake stoma care and using best practice techniques and products.

The standards appear to reflect those set out in the draft document seen by the Secretariat last month.

The changes under consultation for medicines management would enable nurses and midwives to be able to prescribe much earlier in their careers than they can at the moment, with an aim for all nurses and midwives to be ‘prescribing ready’ when they register with the NMC. The NMC concluded that the Royal Pharmaceutical Society (RPS) was the best placed organisation to set standards around prescribing, and nurses who prescribe will do so in line with the RPS Competency Framework. The NMC is also proposing withdrawing its standards for medicines management, and signposting to other organisations that are better placed to produce up to date guidance on safe and effective medicines management.

The document outlines requirements for community practitioner nurse prescribers, nurse independent prescribers, and supplementary prescribers. It also sets out requirements for prescribing programmes in general terms, which no specific mention of continence.

Hunt hints at end to pay restraint for nurses

Jeremy Hunt used a keynote speech at the NHS Confederation Conference to suggest the Government’s public sector pay freeze might be coming to an end, saying that he had “a great deal of sympathy for the case that nurses have made on the issue of pay”. The Health Secretary told healthcare professionals and managers at the conference that he would meet with the Chief Executive and General Secretary of the Royal College of Nurses, Janet Davies, and make sure the conversation is reflected back to the chancellor before we make (a decision on the pay freeze).” However, in response to a question about austerity, Hunt indicated the overall decision on pay would be out of his hands and rely on a decision from the chancellor in consideration of the entire public sector. The BBC has reported that government sources are confirming the issue is on the agenda.

NHS England Chief names first Accountable Care Systems

Simon Stevens revealed the “first wave” of eight Accountable Care Systems in the UK, during his speech at the NHS Confederation Conference on Thursday. The areas will be granted additional transformation funding and some devolved responsibility and accountability from the national level for integrating services. The eight areas are almost identical to the indicative list published in NHS England’s Next Steps on the Five Year Forward View document in March, although Buckinghamshire has been brought in, with Northumberland missing out from the original list. The eight ACS areas are:

  • Frimley Health;
  • South Yorkshire and Bassetlaw;
  • Nottinghamshire;
  • Blackpool & Fylde Coast;
  • Dorset;
  • Luton, with Milton Keynes and Bedfordshire;
  • West Berkshire; and
  • Buckinghamshire.

Stevens said that the areas have the “combined indicative potential to control around £450m of funding over the next four years” to help deliver “fast track improvements” in national clinical priorities such as cancer and mental health, investing in primary care to improve access and reducing the strain on emergency departments.