Weekly political news round up – 16th February 2018

February 20, 2018 in News by Whitehouse

This week, both Houses of Parliament have been in recess and will return to business on Tuesday 20th February. NHS England has launched a campaign to encourage parents to seek advice from pharmacists for their children’s minor illnesses, and the Royal College of Nursing has warned that the Treasury still needs convincing of the need for a “meaningful” pay rise for nurses. The RCN has also called for the Government to encourage EU nurses to stay in the UK after Brexit, while Boris Johnson called for unity on the UK’s vision for Brexit in a speech.

NHS England launches campaign to use pharmacists for minor illnesses

NHS England has launched a new campaign advising parents to visit pharmacists to address their children’s minor illnesses, in order to speed up treatment and reduce pressure on GPs. The Stay Well Pharmacy campaign highlights that 35% of parents with children under five would take the children to a GP if they had a minor illness such as earache or diarrhoea, and 5% would visit A&E. The spending on NHS staff time and treatments for these minor, “self-treatable” conditions is estimated to cost £850 million a year.

Dr Bruce Warner, deputy chief pharmaceutical officer at NHS England, said that pharmacists can “assess symptoms and recommend the best course of treatment or simply provide reassurance”, and “have the right clinical training to ensure people get the help they need” if conditions worsen. The Royal College of Paediatrics and Child Health welcomed the advice, saying “We all need to emphasise that alternative resources are available to parents and caregivers when they have less serious concerns about the health of their child” – but the Royal College of GPs warned that “in an emergency or situation were genuinely unsure, patients should always seek expert medical assistance.”

Treasury still needs convincing of “meaningful” pay rise for nurses

The Chief Executive of the Royal College of Nursing (RCN), Janet Davies, has discussed the RCN’s negotiations with the Treasury on increases to nurses pay, warning that the Treasury still needs convincing of a “meaningful” pay rise for the workforce. While Davies recognised that it is a “big thing” that talks are even taking place, she said “The health team really understand the need for a pay rise, the Treasury doesn’t”, and there is further negotiation for this to be funded with additional funding rather than out of existing NHS budgets. She also highlighted the fact that the ‘Agenda for Change’ pay system, pay rises would have to be considered for other NHS staff as well as nurses.

Davies made the comments at a conference at the University of Salford last week. A government spokesperson said “The government has been clear that it will fund a multi-year pay deal for staff employed under the national Agenda for Change contract — including nurses and midwives – if talks on contract reform are successful.”

RCN says EU nursing staff must be encouraged to stay in UK

The RCN has responded to a report published by the Home Affairs Select Committee on Brexit and immigration, calling for assurances to be made that nurses and carers from the EU will have the right to stay in the UK after Brexit. The Committee’s report expresses concerns around the proposal to extend the current immigration system for nurses, as prioritising visas based on salary levels would preclude many EU nurses from coming to the UK.

Janet Davies of the RCN said, “In some hospitals, one in five NHS workers have EU passports – if there is a Brexit cliff-edge in migration, it will be the NHS going over it.” The RCN further advised the Government to launch a consultation on immigration arrangements after Brexit and the impact on public services.

Boris Johnson calls for unity on Brexit vision

Boris Johnson has made a speech calling for unity on the vision for Brexit, as part of a week of speeches from the Prime Minister, the Brexit Secretary and the International Trade Secretary examining the future relationship the UK want to have with the EU. Johnson’s speech attempted to reconciliate divisions between those who voted to leave and remain in the EU, stating “We must accept that many [Remainers] are actuated by entirely noble sentiments, a real sense of solidarity with our European neighbours and a desire for the UK to succeed.”

Johnson expressed his doubts that membership of the customs union and the single market brings economic benefits, saying that “the economic benefits of membership are nothing like as conspicuous or irrefutable as is sometimes claimed.” Responding to Johnson’s speech, the shadow Brexit secretary Sir Keir Starmer said “Nobody will be fooled or reassured by the foreign secretary’s empty rhetoric.” The pro-EU Labour MP Chuka Umunna also described the speech as “an exercise in hypocrisy”, while the SNP’s Brexit spokesperson Stephen Gethins criticised the Government for still not being able to explain “what leaving the EU will mean.”

Weekly political news round up – 9th February 2018

February 20, 2018 in News by Whitehouse

This week, NHS England has published refreshed planning guidance for 2018/19 to set out how it will deliver on the aims of the Five Year Forward View and spend the additional money allocated to it. It has also been reported that NHS England has “abandoned” its plan for a forward view for community services. Derek Thomas has been elected to the Health Select Committee, and the Welsh NHS has allocated £100 million to invest in new models of care.

NHS England publishes refreshed planning guidance for 2018/19

NHS England has published refreshed planning guidance for 2018/19, to take into account the additional £1.6 billion of NHS funding announced in the Budget and outline what needs to be delivered on existing priorities for the year. The guidance confirms that Accountable Care Systems are being renamed to Integrated Care Systems (ICSs), which are described as systems in which “commissioners and NHS providers, working closely with GP networks, local authorities and other partners, agree to take shared responsibility (in ways that are consistent with their individual legal obligations) for how they operate their collective resources for the benefit of local populations”, on a voluntary basis and in an integrated manner. There is also an expectation stated in the document that all STPs will eventually become ICSs.

The document states that eight areas are currently deemed ‘shadow’ accountable care systems and will only become ICSs once they have produced “a credible plan that delivers the system control total”, which will enable some organisations within an ICS to go over their control total as long as others go under and the overall system total is still met. Those ICSs that do not meet their control totals will not be eligible to access additional funding allocated to a Provider Sustainability Fund (PSF). The Chief Executive of the NHS Confederation, Niall Dickson, warned that the allocation of the extra funding “comes with too many strings attached”, but praised the recognition that CCGs need support to use their budgets more flexibly within a local area.

NHS England has “abandoned forward view” for community services

It has been reported that NHS England has abandoned its intention to create a “forward view” plan for community services, despite the proposal being included in a previously leaked document. The community services framework would have been used to fully redesign community services to support the ambitions of STPs; achieve efficiency savings associated with moving care into the community; and deliver on targets set out in the General Practice Forward View to ensure primary and community care can work together.

The decision not to publish a forward view for community services has been criticised, with Matthew Winn, chair of the Community First Network, saying “community services consume around 10 per cent of the NHS budget, yet the infrastructure and leadership in national bodies is virtually non-existent. It is time NHS England and partner arm’s length bodies backed up their rhetoric of moving care closer to home with the resources and infrastructure to make this happen.”

Derek Thomas elected to Health Select Committee

It has been reported on Conservative Home that Derek Thomas has been elected to the Health Select Committee. Thomas will be replacing Maggie Throup, who was appointed as a Parliamentary Private Secretary to the Department of Health and Social Care ministerial team. While it was also reported that Martin Vickers was elected to the Committee, it is not clear who he would be replacing, and this has not been reported elsewhere.

Thomas has been the MP for West Cornwall since 2015, and said that he is “determined to do what I can to ensure that the NHS works for one and all and that we properly integrate health and social care.” Before becoming an MP, he ran a small business and had worked in the voluntary sector as an outreach worker for the Church of England and as a Youth and Community Manager for a Methodist Church.

Welsh NHS allocated £100m to invest in new models of care

The Welsh Government has allocated £100 million to invest in new models of care, as part of its Transformation Programme to integrate community and primary care services. The funding will deliver on the recommendations of the Parliamentary Review of Health and Social Care, and the Welsh Health Secretary, Vaughan Gething, said he hoped it would be used to create “new, bold and innovative ways of delivering services to secure a sustainable future.” The programmes which it will fund will be similar to the vanguard projects in England.

The associate director of RCN Wales, Helen Whyley, welcomed the money but warned that “This funding must be invested in transforming the NHS in Wales to provide better facilities and resources and not propping up existing budgets and duplicating current services.”

Weekly political news round up – 2nd February 2018

February 20, 2018 in News by Whitehouse

This week, a parliamentary question has been answered on NHS England’s assessment of the implementation of the Excellence in Continence Care guidance. The Nursing and Midwifery Council has highlighted the opposition expressed to some of the changes it has proposed to nurse education, and the King’s Fund has said that the level of public support for the NHS will prevent it from being privatised. The former Children’s Minister Edward Timpson has also been appointed as an adviser to the Children’s Commissioner Anne Longfield.

Parliamentary question on Excellence in Continence Care guidance

The Labour MP David Drew has received an answer to a written parliamentary question on what plans the Department of Health and Social Care has “to ensure that all clinical commissioning groups implement NHS England’s Excellence in Continence Care guidance.” The question received a response from Public Health and Primary Care Minister Steve Brine, who clarified that NHS England is:

  • Arranging for CCGs to access teams of expert clinicians, commissioners from areas that have adopted the guidelines and people with experience to review their existing service against the guideline and make appropriate improvements;
  • Exploring the potential for a mandatory data set to provide transparency about the continence service CCGs are commissioning via the CCG assurance process which enables NHS England to check how CCGs are meeting the health needs of their population;
  • Encouraging CCGs to develop integrated commissioning arrangements with local authorities to ensure improved coordination, experience and use of resources; and
  • Ongoing communication and education campaigns to raise awareness about the Framework.

Nursing and Midwifery Council faces opposition to education changes

The Nursing and Midwifery Council (NMC) has highlighted opposition to the changes to nurse education it proposed last year, with the consultation receiving 1,932 responses from individuals and organisations. Early analysis of the consultation was included in NMC council papers and reported in the Nursing Times. Some of the main areas of disagreement were whether all student nurses should have to be competent in the same communication and relationship skills regardless of whether they were training in adult, children, learning disabilities and mental health nursing and whether the maximum number of hours which a student can spend in simulation as part of their practice should increase beyond 300. The NMC noted that “there is a widely held conviction that simulation should not be seen as a substitute for hours spent in practice settings.”

The NMC indicated it would not change its stance on controversial issues if it has other evidence to support its stance, saying that plans will not be dictated like “the X Factor vote” and be led by popular opinion. The NMC’s separate consultation on withdrawing its standards for medicines management received mixed responses, with 40% of respondents disagreeing with the plans, 27% agreeing and 33% not having a view either way. The NMC’s director of education, Geraldine Walters, said “We’d already taken account of evidence, recommendations in national inquiries, and took the view of stakeholders and experts.”

King’s Fund: public support will prevent NHS privatisation

A report by the think tank the King’s Fund has argued that the NHS is not at risk of being turned into a US-style private system, as many campaigners fear the Conservatives are trying to do, as public support for its current funding model is too strong to allow for a change. The King’s Fund analysed 34 years of data from the British Social Attitudes survey which reflected consistently high levels of support among the public for the NHS, suggesting that “for anyone in politics who was trying to privatise the funding of the NHS, it would be an act of political suicide.”

Edward Timpson appointed as Children’s Commissioner adviser

The former Children’s Minister Edward Timpson, who lost his seat at the last general election, has been appointed as a part-time adviser to the Children’s Commissioner Anne Longfield. Timpson will advise Longfield on how her powers can be used to promote and protect children and young people, as well as what the priority issues and challenges are for children, families and the sector. As a former minister, Timpson had to seek approval for the appointment from the Advisory Committee on Business Appointments and cannot lobby the Government on issues relating to the role for the two years from his last day in ministerial office.

Weekly political news round up – 26th January 2018

February 20, 2018 in News by Whitehouse

This week, there has been wide public debate on NHS funding, following a call from the Foreign Secretary Boris Johnson for the NHS to receive an additional £100 million a week. It was reported that Johnson would make the demand during a Cabinet meeting on Tuesday, following his well-publicised campaign for the NHS to receive an extra £350 million a week during the Brexit referendum campaign, but his demands were dismissed by the Prime Minister. While his call was rejected in the Cabinet meeting, the coverage is thought to have sparked wider discussion of NHS funding within the Cabinet.

RCPCH publishes ‘State of Child Health – One Year On’

The Royal College of Paediatrics and Child Health (RCPCH) has published scorecards evaluating the approach to child health in England, Scotland and Wales to mark a year since the publication of its State of Child Health report. The scorecards highlighted that England has not made sufficient progress in child health for a number of reasons, including that it has not made plans for an overarching child health strategy, taken action on junk food advertising or increased investment in child health research. Scotland was praised for its work to pass the Child Poverty (Scotland) Act and plans to increase the number of health visitors by 500 by the end of 2018, while Wales was commended for passing the Public Health (Wales) Act and its provisions on smoking in public places.

Commenting on the scorecards, the RCPCH’s Officer for Health Promotion, Professor Russell Viner, said “Child health isn’t being given the political attention it deserves in Westminster, which is disappointing given the real commitments from the Scottish and Welsh Governments. […] Getting it right in childhood means setting up future generation for a lifetime of better health. Investing in children is an investment in the entire population.” The RCPCH’s President Professor Neena Modi also called for a “reversal of the current destructive cuts to preventive services.”

King’s Fund calls for ‘forward view’ for NHS community services

The health think tank The King’s Fund has published a report, ‘Reimagining community services’, calling for NHS community services to be reinvigorated to deliver on the NHS’s ambitions over the coming years. The report contains a list of services falling under a ‘narrow definition’ of NHS community health services – meaning that they are provided by organisations with responsibilities in this area, such as community trusts, private providers and local authorities – including child health services, community paediatric clinics, and community specialist nurses for issues including continence, health visiting and school nursing. Specialist continence nurses are referenced at several points in the report as examples of the type of community support people might come into contact with.

The report recommends that “National bodies should publish a plan for the future of services in the community, akin to the General practice forward view, setting out a compelling vision for the future and the resources that will be provided to make a reality of this vision.” The authors emphasise that community services cannot be boosted by redistributing capacity and resources from acute care when hospitals are under such intense pressure, and so the community sector should benefit from additional NHS funding. This should be accompanied by “an honest assessment of what funding and staffing are needed as budgets are likely to be constrained for the foreseeable future.”

Health Committee publishes report on nursing workforce

The Health Select Committee has published its final report on the nursing workforce, which highlighted the issues contributing to the shortfall in the nursing workforce including “workload pressures, poor access to continuing professional development, a sense of not feeling valued, ongoing pay restraint, the impact of Brexit and the introduction of language testing.” The report calls for an expansion to the nursing workforce to relieve “relentless pressures which, at their most extreme, meant that nurses felt their professional regulations were at risk because they were struggling to cope with demand.”

The Committee also reiterated the warning from elsewhere in the sector that the Government’s promise to fund pay increases for NHS staff with links to productivity may not be realistic, and that the Government should “recognise the existing pressures on, and productivity gains by, the nursing workforce.” The Chief Executive of the RCN, Janet Davies, said “It’s clear the Health Committee has listened to the views of frontline nursing staff and made practical suggestions on what must be done to value the profession to improve retention and raise morale. The Government must now also listen and respond to these recommendations.”

DHSC publishes single departmental plan

The Department for Health and Social Care (DHSC) has updated its single departmental plan to reflect new ministerial responsibilities following the reshuffle. The plan was originally published in December and sets out the department’s objectives for the coming year. These are broken down into five objectives:

  • Keep people healthy and support sustainable public services
  • Transform out of hospital care to keep people living healthier for longer in their community
  • Support the NHS to deliver high quality, safe and sustainable hospital care and secure the right workforce
  • Research and innovate to maximise health and economic productivity
  • Ensure accountability of the health and care system to Parliament and the taxpayer, and create an efficient and effective Department of Health

 The Department intends to strengthen the public health system by working with Public Health England to “refresh assurance, funding and transparency for local authority public health responsibilities”; and to develop community pharmacy to “provide a more efficient service while maintaining patient access and improving quality.” It will also implement previously announced reforms to the nursing workforce, including “a 25% increase in training posts for nurses and a further 5,000 nursing associates to be trained through the apprenticeship route in 2018 and 7,500 in 2019.”

Weekly political news round up – 19th January 2018

February 20, 2018 in News by Whitehouse

This week, the Government has confirmed that it will continue to cut the public health funding allocated to local authorities in 2018/19 and 2019/20; it has been reported that the NHS is now losing 10% of its nurses each year; and the Welsh Government has published its Parliamentary Review of Health and Social Care.

Public health budget to be further reduced

The Government has confirmed that it will continue to cut the public health funding allocated to local authorities in 2018/19 and 2019/20, with a loss of £85 million in funding for each year. The reductions equate to a 5% reduction from existing allocations, and are on top of previous reductions announced for budgets up to 2020/21. Izzi Seccombe, Chair of the Local Government Association’s community wellbeing board, said that “The government announced an extra £2.8bn for the NHS in the autumn budget. But to then take vital money away from the services which can be used to prevent illness and the need for treatment later down the line and ease the pressure on the NHS is extremely counter-productive.”

The Government also confirmed that it will change how public health funding is distributed from 2020, by allowing local authorities to retain their own business rates which are currently collected centrally and then redistributed in a grant. The chief executive of the Association of Directors of Public Health, Nicola Close, warned that this could exacerbate health inequalities in poorer areas that do not receive as much business rate income.

NHS losing 10% of nurses each year

Statistics have emerged this week demonstrating that one in ten nurses left the NHS in each of the last three years, with 33,000 leaving last year. The figures mean that more nurses are now leaving the NHS than joining, and in 2016/17 3,000 more nurses left than joined the health service. The issues have been attributed to workload pressures within the NHS and Brexit, as more EU nurses are now leaving than coming to the UK to work for the NHS. The head of the Royal College of Nursing, Janet Davies, said “The next generation of British nurses aren’t coming through just as the most experienced nurses are becoming demoralised and leaving.” The Department of Health said that initiatives are being implemented to tempt nurses to stay in the workforce, including transfers to different jobs, mentoring and staff awards.

Welsh Government publishes Parliamentary Review of Health and Social Care

The Welsh Government has published its Parliamentary Review of Health and Social Care, following a consultation on the subject last year. The report makes ten recommendations to the Welsh Government on how to improve health and social care in Wales, and how to achieve improvements to health and social care by focusing on a ‘Quadruple Aim’ of:

  • Improving population health and wellbeing by focusing on prevention;
  • Improving the experience and quality of care for people;
  • Enhancing the wellbeing, capability and engagement of the workforce; and
  • Increasing the value achieved from health and care through innovations and efficiencies.

Some of the key recommendations include working on introducing new models of “seamless care”, with the need to develop these models rapidly and reorient “specialised care”. The report also recommends harnessing innovation and accelerating technology and infrastructure developments to deliver “more effective and efficient care”; and endorses designing the system to improve incentives, regulation, planning, targets and performance management to achieve faster progress. There is also a consistent emphasis on involving patients and the public when making changes.

Responding to the report’s publication, the Chair of the Welsh NHS Confederations, Bernadine Rees, said “We are particularly pleased the report recognises the need to involve the public in the design and development of new service models. The citizen voice must be part of the solution to the challenges we face, with people being empowered to be actively involved in their own health and wellbeing.”

CQC chief executive to stand down in the summer

The chief executive of the Care Quality Commission, Sir David Behan, has announced this week he will step down from the organisation in the summer after six years. The CQC will begin its search for his replacement immediately, and the Health Secretary said of Sir David’s resignation that “he deserves great credit for overhauling healthcare regulation in this country to put quality and safety at the heart of the ratings system.” Sir David highlighted that during his tenure the CQC has “inspected every hospital, adult social care provider and GP practice in the country – over 28,000 services and providers – and in the process developed a baseline on quality that is unique to anywhere in the world.”

Weekly political news round up – 12th January 2018

February 20, 2018 in News by Whitehouse

Theresa May completed the reshuffle of her cabinet this week, implementing a moderate shake-up of her senior team while promoting a number of younger, female and minority ethnic MPs to junior ministerial posts. The Prime Minister was expected by some to implement the most radical alteration of the Cabinet in her short tenure as Prime Minister, but the principal offices of state – including the Home Office, Foreign Office, and Treasury – were unchanged with Amber Rudd, Boris Johnson and Philip Hammond remaining in post.

The highest profile casualty of the reshuffle has been Justine Greening whose 3-hour meeting with Theresa May on Monday night easily surpassed protracted negotiations over the roles of Jeremy Hunt and the Business Secretary Greg Clark earlier that day. The Education Secretary resigned from government by refusing to take up an alternative role at the head of the Department for Work and Pensions. Greening is succeeded by Damian Hinds; with former DWP minister Esther McVey becoming Secretary of State for Work and Pensions.

The Prime Minister sought to elevate the importance of housing and social care in 2018 by bolstering the portfolios of Sajid Javid – now Secretary of State for Housing, Communities and Local Government – and Jeremy Hunt – now Secretary of State for Health and Social Care. Despite this, Theresa May has earned few plaudits for a reshuffle that was seen as a chance to shift the negative political narrative overshadowing the work of her government, and has been criticised even by generally supportive publications.

Jeremy Hunt stays on as Health and Social Care Secretary

Jeremy Hunt has remained in charge of the health service after being handed an enhanced portfolio by the Prime Minister in her Cabinet reshuffle. The Prime Minister met with Hunt for the best part of Monday afternoon before officially moving the Surrey West MP into a new post as “Secretary of State for Health and Social Care.” He was tipped by many commentators to be promoted into the vacant First Secretary of State post created by Damian Green’s resignation and, later on Monday afternoon, rumoured to be taking a sideways move to the Department for Business, Energy and Industrial Strategy. Hunt will soon become the longest tenured Health Secretary in the history of UK politics.

The addition of “and Social Care” to his job title is at least significant to the extent that Hunt will oversee the social care green paper, set to be published in 2018, a task previously in the hands of Damien Green at the Cabinet Office. Chair of the Commons Health Committee Sarah Wollaston tweeted her support for the ‘new’ post on Monday evening, saying it is, “really encouraging to see both health and care together”. Wollaston has been pushing for the creation of a cross-party summit on health and social care funding in recent months and added in her tweet, “now we need the long-term planning and sustainable funding for the scale of increased demand and costs.”

Norman Lamb claimed the change was simply “window dressing… unless (the Government) is proposing to change funding of social care.” No significant reshuffle of responsibilities is expected for junior ministers within the Department of Health following Hunt’s reappointment.

For at least the third time since the 2015 election, Jeremy Hunt has become the unlikely survivor of a
major government reshuffle. Both Hunt and Business Secretary Greg Clark remained at Number 10 for over an hour on Monday afternoon to learn of their fates, with BBC political editor Laura Kussenberg reporting that Hunt was due to take Clark’s post, before convincing the Prime Minister of the need to keep him in Health and Social Care.

Two ministers appointed as Phillip Dunne leaves DH

Two Conservative MPs have been promoted to take on ministerial roles at the renamed Department for Health and Social Care. Stephen Barclay, MP for North East Cambridgeshire, has moved from his position as Economic Secretary to the Treasury, while Caroline Dinenage, MP for Gosport, comes across from the Department for Work and Pensions, having previously held junior posts in Education and Justice.

Barclay has not previously held a health role, although in 2013 he held an adjournment debate on the regulation of health professionals after the scandal at Mid Staffordshire following the death of a young constituent whose condition was misdiagnosed. He has campaigned to make it easier to sack doctors for misconduct. Barclay was previously a whip, before being appointed City Minister in June 2017 with extensive experience in financial law, and is also a former member of the Public Accounts Committee. Dinenage also has limited experience in health, but has been a government minister across three departments since joining the Ministry of Justice in 2015 and has 20 years’ experience as a small business owner.

Both Barclay and Dinenage have consistently voted against restricting the provision of services to private patients by the NHS, in favour of smoking bans, and reforming the NHS so GPs buy services on behalf of their patients. Jackie Doyle-Price Steve Brine and Lord O’Shaugnessy have all remained as Parliamentary Under Secretary of States in the department, whist Health Minister Philip Dunne has been removed from his role as Health minister.

New Secretary of State and Children’s Minister appointed at DfE

Damian Hinds, MP for East Hampshire, has replaced Justine Greening as Secretary of State for Education. Ms Greening had been widely tipped to lose her place in the reshuffle having disagreed with the Prime Minister over the Government’s proposed grammar school programme. In the end, she was offered the role of Secretary of State for Work and Pensions but refused the post and resigned from the Cabinet. Ms Greening’s departure comes at a crucial time for many of the reforms initiated during her short tenure including the Opportunity Area policy and consultations on strengthening qualified teaching status and the formation of a new sex and relationship education curriculum.

Mr Hinds 48, was born in London, went to a Catholic grammar school in Cheshire and read politics, philosophy and economics at the University of Oxford (where he chaired the Oxford Union). He was previously employment minister in the Department for Work and Pensions, where he faced questions on the roll-out of Universal Credit. Prior to his appointment in July 2016 he was exchequer secretary to the Treasury, and before that, a whip. He sat on the Education Select Committee between 2010 and 2012 and chaired the All-Party Parliamentary Group on Social Mobility, an area of policy which he says he is passionate about. When a member of the group he noted that giving preschool children essential skills was the key to breaking Britain’s class system.

Children and Families’ Minister Robert Goodwill, has left the Government. Nadhim Zahawi, MP for Stratford-on-Avon, has been appointed Parliamentary Under Secretary of State for Education. While it has not been confirmed, he will likely take Mr Goodwill’s portfolio. He co-founded the influential polling company YouGov and is a former government apprenticeship tsar. He has not previously worked in the Department for Education or in the health or education spaces.

School Standards minister Nick Gibb MP, and Skills minister Anne Milton MP, and School System Minister Lord Agnew, have remained as ministers.

Evidence of ‘worst ever’ winter NHS crisis mounts

Sky News has reported on the worsening of the NHS winter crisis, as figures show that in December nearly 15 percent of England’s A&E patients had to wait over four hours to be seen, significantly under the aim of less than five percent. This is the joint worst figure on record, and one percent worse than the performance in January 2017. 95 percent of NHS hospital beds in acute wards in England were fully occupied, which is the highest level since 2010, and there was a significant increase in the number of beds that were closed because of norovirus, diarrhoea and vomiting, from 731 in the week before to 944.

The figures also showed that last week hospital admissions doubled on the week before, from 4.89 per 100,000 to 7.38 per 100,000; 11 trusts reported having no beds available on Sunday. 16,690 patients were also kept waiting in an ambulance for more than 30 minutes before they could be handed over to A&E, which represents a slight improvement on the week before. However, 5,082 patients were kept for over an hour, which is an increase from the 4,734 patients in the previous week.

A group of senior doctors wrote a letter to the Prime Minister outlining their experiences working in A&E over the past few weeks. In the letter, they said, “Some of our own personal experiences range from over 120 patients a day managed in corridors, some dying prematurely”.

An NHS England spokesperson noted that “despite the clear pressure on the NHS in December, with rising levels of flu and record numbers of 111 calls and hospital admission, we managed to hold A&E performance at the same level as last January.”

Public Health Budget faces five percent cuts over next two years

After the NHS was given £2.8bn extra money in the Autumn Budget last year, Pulse has reported that the Government still plans to implement the 2015 autumn budget decision by former Chancellor of the Exchequer George Osborne to reduce the public health budget by 9.6 per cent between 2016-17 and 2020-21. This plan will result in five percent less funding for public health at the end of the period compared with today, equating to £170m less cash for local authorities.

Cllr Izzi Seccombe, chair of Local Government Association’s community wellbeing board, called the cuts “extremely counterproductive” outlining that the funding helped to “prevent illness and the need for treatment later down the line and ease the pressure on the NHS.”

Dr Dominique Thompson, a GP in Bristol, likened the cuts to “reducing seat belt use” as “public health is by definition preventive medicine” and said that the likely consequence of the cuts is an increase in demand for GP services. She opined that funding cuts were targeted at “soft” services such as smoking cessation and sexual health services “because people tend not to take to the streets waving placards asking for chlamydia and gonorrhea screening.” A GP partner practicing in Nottinghamshire, Dr Steve Kell, had its smoking cessation services cut and noted that many other practices had already lost such services and that cuts have led to a “fragmented system” that resulted in the loss of having a holistic approach.

A Department of Health spokesperson said, “we also have a strong track record on public health. Cancer survival and dementia diagnosis are at a record high whilst smoking rates and teen pregnancies are at an all-time low. Over the current spending period we will invest more than £16bn in local government public health services.”

Weekly political news round up – 5th January 2018

February 20, 2018 in News by Whitehouse

The Prime Minister has come under pressure during one of the busiest weeks of the year for the NHS as winter pressures begin to take their toll. Theresa May is hoping to shift the political narrative away from difficulties facing the health service with the help of a widely-anticipated cabinet reshuffle in the coming days, in which the Health Secretary Jeremy Hunt has been tipped by some to be promoted. Jeremy Hunt made several media appearances in support of the Prime Minister’s decision to sack First Secretary of State Damian Green as the result of a computer pornography scandal in the lead up to Christmas and is the favourite to replace Green if Theresa May decides to again fill the post.

However, there are mixed views on the wisdom of such a move for Hunt from within the Conservative Party. While an ally of the Health Secretary told the Sunday Times that Hunt, “is a peacemaker and negotiator” and would be perfect to fill Green’s role in Brexit discussions with the devolved nations, senior Conservatives have warned that Hunt is considered “toxic” by some sections of the public following his long-running dispute with junior doctors during David Cameron’s premiership.

May apologises for delays to operations

Theresa May has issued an apology to patients for thousands of cancelled elective operations, which were ordered by NHS bosses to free up winter capacity in hospital emergency departments. The Prime Minister said she recognised the difficulty caused for patients by delays and cancellations and said, “I know it’s frustrating, and I know it’s disappointing for people, and I apologise.” May’s apology came one day after she denied the service is in crisis and claimed the NHS is “better prepared for this winter than ever before”.

May’s comments on winter pressures followed a decision by NHS bosses on Tuesday to extend a moratorium on non-urgent medical procedures across England until the end of January. It is estimated that this will result in the postponement of around 50,000 operations in total. The decision was made by a new national emergency pressures panel which has been specifically convened for the first time this winter to respond to significant seasonal stress on the service. Some of the pressures on NHS capacity are being caused by the increasing incidence of admissions for flu as a result of the cold weather. 24 people died from flu last week, which is more than the total number of flu deaths in the final three months of 2016.

Jeremy Hunt joined the Prime Minister in apologising for delays saying, “if you are someone whose operation has been delayed I don’t belittle that for one moment.” However, the Health Secretary sought to downplay the scale of winter pressures this year, saying that, in contrast, hospitals were cancelling operations the night before they were due to take place in 2016. He also argued the NHS has now put in place a “planned, methodical and thoughtful” approach to dealing with increased demand for care in this winter.

Wollaston calls for new taxes as patients wait in ambulances

The Chair of the Health Committee Sarah Wollaston has criticised the government for its approach to NHS finances, saying it needs to “get a better grip” on the challenges facing the service. Wollaston has also called for a new tax on people over the age of 40, specifically to provide additional revenue for the NHS. She argued that the cost of extra funding – predominantly used to support older people in need of additional health and social care support – should not fall disproportionately on younger people and should be spread “across the generations”.

Wollaston argued, “people are happier to pay” taxes which are directly linked to NHS funding, and her proposal gained support from other prominent Conservatives, including Health Committee member Johnny Mercer who called on the Government to examine a ringfenced, “hypothetical tax”. Nick Timothy, the former Chief of Staff to Theresa May, endorsed the concept of increased national insurance contributions from older taxpayers.

Calls for a new approach to taxation come at the end of a week where at least 16 hospitals have declared an emergency situation, and almost 17,000 people were kept in the back of ambulances while waiting to be assessed in A&E. One in six ambulance patients waited 30 minutes or more for admission.

The Government’s management of the NHS has also been criticised by opposition parties and stakeholders across the NHS. Labour Health spokesperson Jonathan Ashworth said, “Tory underfunding and cuts have left our health service more vulnerable than ever” and called on Jeremy Hunt to urgently tell the public “how many more people will be waiting longer in pain and anguish” as winter pressures continue. Lib Dem spokesperson Norman Lamb argued the situation is “wholly predictable”, while Head of Policy at the Patients Association John Kell blamed the policy decisions taken by the Government and said, “ministers must be held accountable for this winter’s crisis.”

GP app providers will be subject to CQC rating

The Department of Health has announced that “all healthcare organisations … that offer regulated care” will now be subject to CQC rating in order to “futureproof” healthcare in England. Currently, the CQC can only inspect and publish findings on, and award ratings to hospital care, social care and GPs. The new powers will expand the Commission’s remit to rate over 800 more practitioners, including independent doctors using apps and digital healthcare. These organisations will be compelled to display their CQC ratings, as is standard procedure for the providers it rates, to “bring increased transparency” to patients and empower them to make informed decisions.

The CQC will launch a consultation this month on how best to carry out rating these providers. It the meantime it will continue to inspect these services and publish findings, and hopes to start awarding ratings to these providers by the end of the year. This further bolsters the CQC’s powers, after its remit was expanded last year to cover independent healthcare providers of services such as cosmetic surgery, misuse services and abortion clinics. The Government has also considered making CQC ratings “the default way [it] presents judgments from all its inspections.”

Health Secretary, Jeremy Hunt, said that the changes will ensure the Department is able to “keep pace with the changing landscape of healthcare” as well as the patients who use it. Sir David Behan, Chief Executive of the CQC, said that the expanded remit will give the public “increased transparency” about the quality of their healthcare service providers. The Department of Health specifically noted Push Doctor and Babylon as examples of independent providers offering digital services that will now be regulated. The widely advertised GP at Hand smartphone app – operated by Babylon – which provides free online consultations with an NHS GP, has caused controversy in recent months as primary care workforce representatives have accused the service of “cheery picking” younger and healthier patients for short-notice appointments.

Weekly political news round up – 22nd December 2017

February 20, 2018 in News by Whitehouse

This week, winter pressures have begun to take their toll on the health service as thousands of patients are set to face delays in having surgery. NHS England has told hospitals to delay elective procedures – such as cataract removals and hip and knee replacements – until mid-January in an attempt to avoid a full-blown crisis in capacity over the winter. The national commissioning body has told NHS trusts already facing “high levels of operational pressure” to convert space normally used for such procedures into overflow areas with beds for patients in need of acute care. National Medical Director Bruce Keogh said the move would be necessary in some parts of the NHS to ensure “care for our sickest patients”, while the patient charity National Voices called the development a “sorry state of affairs”.

Meanwhile, the first of two recent applications for judicial review of accountable care organisations has been granted permission to proceed by the courts. The claim for a review made by campaign group 999 Call for the NHS was approved by Justice Males on Thursday on the issue of “whether proposed [whole population annual payment] is a scheme of payment for NHS services which is permitted under the Health and Social Care Act 2012.” The campaign group believes payment systems through accountable care will constitute a breach of the national tariff system.

Incontinence data discussed in parliamentary question

Jackie Doyle-Price, the Minister for women’s and children’s health, answered a written parliamentary question from Dr David Drew, Labour MP for Stroud on the availability of data on children with incontinence problems. Specifically, Dr Drew asked the Health Secretary if he would “instruct NHS trusts and Clinical Commissioning Groups to start compiling data on the numbers of children with incontinence problems.”

The Minister said there are “no plans” to instruct local health organisations to collect such data. However, Doyle-Price confirmed that in its business planning for 2018/19, Public Health England “is reviewing whether the new section dedicated to child and maternal health on their Fingertips digital platform would be a suitable place to make data about childhood continence available at a local level.”

NHS England orders cut back on over-the-counter scripts

NHS England is proposing to cut free prescriptions for a range of products which can be accessed over-the-counter at pharmacies, in an attempt to reduce the burden on general practice. It has released a consultation entitled, “conditions for which over the counter items should not routinely be prescribed in primary care”, which has suggested reducing such prescriptions for 33 “minor, short-term health concerns” which NHS England deem to be “self-limiting”, and only requiring self-care. Dependent on
the outcome of the consultation, the resulting commissioning guidance “will need to be taken into account by CCGs in adopting or amending their own local guidance to GPs in primary care.”

The Patients Association has criticised the move, with chief executive Rachael Power saying the move threatened to negatively impact the doctor-patient relationship. While agreeing it is “counterintuitive for the NHS to be paying pounds for something that the individual can buy for pence”, Reeves argued that GP appointments may begin to feel like “a benefits assessment, where (patients) wait to find out at the end whether they will receive support or not.” Helen Stokes-Lampard, Chair of the Royal College of GPs, offered a more measured response saying it was imperative that GPs “retain the right to make clinical decisions about prescribing appropriately for our patients based on the unique physical, psychological and social factors potentially impacting on their health.”

The Guardian reports that the plans will restrict prescriptions to treat health concerns including cold sores, conjunctivitis, mild indigestion, dandruff, haemorrhoids, mouth ulcers, dandruff, head lice, headaches and back pain. NHS England Chief Executive Simon Stevens backed the proposal, arguing the consultation, “gives the public the opportunity to help family doctors decide how best to deploy precious NHS resources.” He said it was essential to free up money to be reinvested in “modern treatments for major conditions such as cancer, mental health and emergency care.”

NHS Improvement to “deliver a balanced NHS budget”

The Department of Health has published a letter to NHS Improvement from Health Minister Philip Dunne, outlining its objectives for the financial year 2017-18. In the letter, Dunne highlights that “key to NHS Improvement’s success will be its delivery of a balanced NHS budget whilst driving improvements in the efficient use of resources and increasing productivity in NHS providers”. The DH ministerial team will hold the organisation to account through a series of formal meetings, as well as mid-year and end of year accountability meetings. The specific objectives set for 2017/18 include:

  • Implementing the recommendations of the Carter Review to boost operational productivity through better use of staff resources and management practice;
  • Providing streamlined support for local health economies by developing and implementing Sustainability and Transformation Plans and other models of accountable care;
  • Seeking to reduce the aggregate deficit for the NHS provider sector to £496 million, on total revenue of around £81 billion;
  • Supporting DH and NHSE to support the Five Year Forward View with the ambition of delivering 2-3% improvements in efficiency each year; and
  • Working with NHS England to roll out the four priority clinical standards for seven-day hospital services to 50% of the population by April 2018 and to the whole population for five specialist
    services (vascular, stroke, major trauma, heart attack and paediatric intensive care) by November 2017.

Update on Brexit and EU (Withdrawal) Bill

The EU (Withdrawal) Bill on has its final committee session on Wednesday, in which amendments to the Bill were discussed and six voted on. After last week’s defeat in Parliament, Mrs May decided to drop on the idea of enshrining the exact date and time of Brexit – March 29, 2019 – in the Bill. The resulting compromise will allow Brexit to be delayed in “exceptional circumstances”. The Committee Stage of the Bill has now been concluded, but the Government still faces two further stages in the Commons before it faces a new challenge in the House of Lords.

In particular one amendment to try and make the UK stay permanently in the customs union saw Labour leader Jeremy Corbyn’s biggest party rebellion to date, with 62 Labour MPs backing the amendment against the Labour whip.

Brexit Minister Steve Baker, also discussed amendments and clauses designed to oblige the Government to publish reports or assessments on specific policy areas ahead of Brexit. In particular, clause 48 of the bill calls for a strategy for the certification of UK and EU medical devices by UK bodies in order to maintain a close-relationship with the EU in the field of medical regulations. Baker highlighted to the chamber that this is the aim of the Government’s strategy and that the UK intends to maintain current close relationships with the EU in this area. This clause was not voted on so will not be part of the bill moving forward.

The bill will now move to the report stage, which gives MPs an opportunity to speak and suggest new amendments to the bill. It will then be discussed at third reading, where MPs will vote on the bill in its entirety. If MPs vote in favour it will sent to the House of Lords to undergo the same process it has been through in the Commons. In the unlikely event it is rejected it will be returned to committee stage in the Commons.

Meanwhile, the Committee on Exiting the European Union has published a series of “sectoral reports” produced by the Government. The Department for Exiting the EU (DExEU) produced the reports as analyses of the current state of important sectors which might be impacted by Britain’s departure from the EU, but emphasised that these are not “impact assessments”. There are 39 reports in total, for sectors ranging from ‘Aerospace’ to ‘Wholesale Markets and Market Infrastructure’, and there is a dedicated 20 page report on Life Sciences included in the release.

Weekly political news round up – 15th December 2017

February 20, 2018 in News by Whitehouse

This week, the Department of Health announced that the NHS will become the first healthcare system in the world to publish statistics on avoidable deaths. The publication of such figures follows a Care Quality Commission report in 2016 which suggested that the NHS was “missing opportunities to learn from patient deaths” and failing to include families in investigations. Jeremy Hunt has since repeatedly insisted that the Government will do more to identify and tackle avoidable deaths, and on Thursday said the programme, “marks a significant milestone in ensuring the NHS learns from every tragic case… to prevent mistakes recurring and ultimately delivering safer care for all patients in the future.”

Earlier in the week, King’s College Hospital Trust Chair Bob Kerslake announced his resignation in a letter to the Guardian, citing underfunding and poor planning, and arguing, “the government… (is) simply not facing up to the enormous challenges that the NHS is currently facing.” Kerslake, having lead the civil service and acted as chairman of one of the country’s largest Trusts, is a highly respected figure in the NHS but his organisation had come under fire from the departing NHS Improvement Chief Executive Jim Mackey, who claimed King’s wasn’t doing enough to reduce its deficit.

Teens need incontinence support at school – study

Research from the University of Bristol has concluded that teenagers with incontinence are at greater risk of underachieving academically, and need more educational support to reach their potential. In the only detailed qualitative study carried out in this area in the UK to date, academics at the University interviewed 20 young people with continence problems, aged from 11 to 19, and found that it was rare for young people to speak about continence problems at school to both friends and teachers, due to fears of being stigmatised, bullied or teased.

The study also identified a need to increase teachers’ awareness of continence problems in young people, and to provide guidance on how best to provide support at school. Its recommendations included providing unrestricted access to toilets during the school day for young people suffering from incontinence, and the researchers said they are “developing a prototype smartphone app to support young people to manage daytime urinary incontinence.” The researchers will work with ERIC and educators to produce online resources for secondary teachers. ERIC chief executive Juliette Randall said, “the powerful stories described in this research give us a strong basis for engaging with schools” to improve the experience of young people with continence issues.

HEE points finger at “millennials” for recruitment issues

Health Education England has launched a consultation on its draft strategy entitled Facing the Facts, Shaping the Future, A health and care workforce strategy for England to 2027 which outlines how the NHS will work to become a model employer over the next 10 years amidst a growing problem with staff recruitment and retention. It highlights that “the NHS is employing more staff now than at any time in its history”, and implies that a poor work ethic in “millennials” – or people considered to be part of Generation Y – is a cause of the healthcare staff recruitment crisis in the UK.

The strategy was reported in the Daily Telegraph under a headline specifically citing millennials demands for “shorter hours and gap years”. It outlines that the paper says the workforce will need to increase by a fifth to meet demand, unless productivity or measures to prevent ill health improve. The article quotes Professor Ian Cumming, Chief Executive of Health Education England, saying that millennials “see work-life balance as paramount” and “unlike previous generations they want to be able to adapt their work schedule to their home life and not the other way around.” He also argued that the increased number of women entering the profession means more staff have needed to be trained to cover the numbers of people working part-time.

The strategy proposes specific measures such as targeted retention schemes, improvements in medical training and support for junior doctors, and making the NHS a more inclusive, family-friendly employer. Emergency medicine is struggling most with staff recruitment and retention, with nearly 16 per cent of posts being vacant, closely followed by acute medical services with 14 per cent. Health Secretary Jeremy Hunt said that this strategy is the beginning of “a proper plan [for the NHS] that stretches beyond any electoral cycle,” while Professor Sir Malcolm Grant, Chair of NHS England, and Duncan Selbie, Chief Executive of Public Health England, both also welcomed the strategy.

The strategy also reveals rising turnover rates in the nursing workforce, with almost 9% of nurses leaving the NHS over the past 12 months, a steady rise from a 7.3% turnover rate in 2012-13. The document states that, “insufficient growth in supply, more retirements, and increased demand for staff are leading to greater competition between trusts for nurses.” The strategy also notes a particular workforce shortage issue with learning disability and mental health nurses, with the number of posts left empty this year at 16% and 14%, respectively. Ian Cumming said there are currently no specific targets for the nursing workforce over the next 10 years, but admitted that “we need more nurses in the mental health environment.”

The Royal College of Nursing welcomed the publication of the draft strategy saying, “the Government has acknowledged that the workforce crisis is the single most important issue facing health and social care today, and we look forward to working with ministers to find properly funded solutions.” However, RCN Chief Executive Janet Davies said the Government “must take responsibility for building a sustainable supply of domestic nurses” and also called on ministers to, “reverse cuts to vital funding for continuing professional development”, that were recently called into question in a Health Committee hearing.

The publication of the draft workforce strategy comes in the same week as the release of an RCN “Nursing Employment Survey”, which found that over a third of nursing staff (37%) report that they are looking for a new job, and close to two-thirds (63%) say they are too busy to provide the level of care that they would like.

Government suffers first defeat on the EU Withdrawal Bill

This week, the Government suffered its first defeat on the EU Withdrawal Bill as several Conservative MPs backed an amendment tabled by Dominic Grieve which will allow parliament a veto on the final Brexit deal. The Government lost the vote by 309 votes to 305 after Grieve, an ex-Attorney General, convinced 10 other Conservative MPs – and almost every opposition MP – to vote to ensure parliamentary oversight on the agreement the UK Government reaches with the 27 remaining EU states.

The first major Government defeat on the Bill underlines the difficulty facing the Prime Minister in governing a party split by opposing views on Brexit. It also represents an untimely setback following the deal the Government secured last week with the EU – and confirmed formally today – to finally move negotiations onto trade and Britain’s future relationship with the EU. In a sign of how seriously the Government took the vote, Julian Smith MP, the new Conservative Chief Whip, is alleged to have threatened legal action against MPs from his party who criticised the pressuring tactics used by the Government. Pro-EU Conservative MP Anna Soubry claimed that one MP had been reduced to tears by the whips’ tactics.

However, the 27 EU leaders have now agreed to move Brexit talks onto the second phase. The transitional period following the UK’s exit will be the first issue to be discussed, following by talks on trade and security cooperation from March. Theresa May described it as an “important step”, although Germany’s Angels Merkel said that the process was likely to get “even tougher” from now on. The follows agreement from the EU Parliament earlier in the week that talks should proceed to the next stage.

The Government will face further challenges with next week’s vote on an amendment to set the UK’s departure date from the EU for 29th March 2019. Pro-EU MPs argue that the specific date will make it more difficult to extend negotiations, whilst MPs favouring a hard Brexit argue that a set date will ensure that the UK does leave the EU even in the absence of a trade deal. In a further demonstration of splintering in the Conservative party, Stephen Hammond MP who was one of 11 Conservative rebels on the vote was within an hour removed as vice-chairman of the Conservative Party.

Weekly political news round up – 8th December 2017

February 20, 2018 in Uncategorized by Whitehouse

This week, Healthwatch England has written to the Health Secretary warning that Healthwatch organisations are unable to do their jobs properly due to funding cuts. It has been reported that there has been an 18% decline in the number of applications to study nursing this year, and Labour has requested that parliamentary time be allocated to debate Accountable Care Organisations (ACOs). The UK has reached an agreement to progress to the next stage of Brexit negotiations, and the Chancellor has confirmed the date of the Spring Statement.

Healthwatch warns Health Secretary over funding cuts

The chair of Healthwatch has written to the Health Secretary calling for “the department to step up its work with Healthwatch England and others in order to maintain an effective Healthwatch network”, after warnings that many organisations have had their budgets cut. The 152 Healthwatch groups across England are funded by local authorities, which have had to pass on funding reductions as a result of their own budgetary constraints. Healthwatch England estimates that funding was cut by £27.4 million, or 6.9%, in 2017/18, and some groups have experienced cuts of up to 17%.

Jane Mordue, the author of the letter to the Government, warned that these cuts are leaving Healthwatch organisations “unable to fulfil their statutory obligations”, as they often cover large geographical areas and can be staffed by as few as two people. The reductions have also had “n unwelcome impact on the ability of local Healthwatch to participate effectively in strategic discussions including work relating to sustainability and transformation partnerships and accountable care systems/organisations”.

18% decline in applications to study nursing

The Royal College of Nursing has expressed concerns around a decline in the number of people applying to study nursing, with an 18% decline recorded in 2017. While the RCN makes clear that this has only translated into a 0.9% decrease in the number of students being accepted onto nursing courses across the UK, the RCN’s Associate Director of Policy and Public Affairs, Lara Carmona, said that “These figures show the future supply of nurses remains in peril – we have not seen the increase we need across the UK, despite government promises.” Carmona also pointed to the Government’s policy to remove student bursaries for nurses to allow numbers to increase by 10,000 and fund a 25% increase in training places, which has not materialised.

The RCN has also expressed concerns this week about the Government’s indication that pay rises for nurses will be linked to improved productivity, at the same time that the Health Secretary has commenced pay negotiations for 2018/19. The RCN emphasised when the Government previously suggested this approach, stating that “Nurses should not be expected in effect to fund their own pay rise. A fair pay rise is vital not just for nursing staff, but for patients and the NHS as a whole.”

Labour calls for parliamentary debate on ACOs

Labour has tabled an Early Day Motion (EDM) calling for the Government to grant parliamentary time to debate the introduction of Accountable Care Organisations (ACOs), which are intended to be the next step on from STPs and Accountable Care Systems (ACSs). The EDM – a type of parliamentary motion stating an opinion of the members supporting it, but which does not necessitate a government response – references a consultation which the Government published earlier this year which proposed changes which would facilitate the regulations needed for ACOs. The motion also states that “these changes will have far reaching implications for commissioning in the NHS, and that concerns have been raised that Accountable Care Organisations will encourage and facilitate further private sector involvement in the NHS, and about how the new organisations will be accountable to the public”.

The EDM was accompanied by a letter from the shadow health secretary, Jonathan Ashworth to the Leader of the House of Commons, Andrea Leadsom, calling for parliamentary time to be allocated to the issue. The letter argued that “the Government has been reluctant to put details of the new arrangements into the public domain. It’s essential that the decision around whether to introduce ACOs into the NHS is taken in public, with a full debate and vote in Parliament.”

UK reaches agreement to progress to next stage of Brexit negotiations

The UK has reached agreement with the EU on key issues which will allow it to move on to the next stage of Brexit negotiations. The main topics being discussed were the Irish borders, the “divorce bill” and the rights of EU citizens in the UK and UK citizens in the EU. The DUP brought talks to a halt earlier in the week by opposing the proposals on the Irish border, and today’s agreement has satisfied these by guaranteeing that there will not be a hard border between Northern Ireland and the Republic. Agreement was also reached that if the UK and EU do not agree a trade deal later on, the island of Ireland will maintain “full alignment” with parts of the single market and customs union, as stipulated in the Good Friday agreement.

Reports have also emerged that divorce bill has been estimated at between £35 billion and £39 billion, which the Prime Minister argued will enable the UK in future to “invest more in our priorities at home, such as housing, schools and the NHS.” The details need to be agreed at a European Council summit next week, and it is then expected to take about a year to agree the details of a future trade agreement between the two sides. Labour welcomed the progress but said that the Prime Minister should “seriously reflect on her approach to the negotiations so far.”

Spring Statement date confirmed

The Chancellor has confirmed that the first Spring Statement will be published on 13th March 2018. It will be the first financial Statement (rather than a Budget) which the Government has made since the Autumn Statement 2016, when it was announced that the Autumn Budget would become the only major fiscal event of the year from 2017. The Spring Statement will be used to respond to the Office for Budget Responsibility’s financial forecasts rather than making financial policy announcements.