Weekly political news round up – 25th May

May 25, 2018 in News by Whitehouse

Overview

There has been much talk in the national press this week about Brexit and arrangements for a Customs Union, with splits in the Cabinet reportedly forming and Government aide, Andrea Jenkyns, leaving her role to ‘fight for Brexit’. Theresa May is also set to ask the EU for a second Brexit transition period to run until 2023 to avoid a hard border in Ireland. The proposal would mean that the whole of the UK will stay aligned with EU regulations and customs procedures until 2023, with the concept predictably being as praised by remainers as roundly criticised by Brexiteers.

Earlier this week, the Government responded to the Health and Select Committee’s report on Brexit: medicines, medical devices and substances of human origin. The Government had been criticised by the committee over what it sees as a lack of contingency planning in the event of a ‘no deal’ scenario. While the Government claims such an event is “highly unlikely”, it provided little new information on the prospects for the pharmaceutical and medical devices sectors post-Brexit, saying, “it would not be appropriate to publish anything that would risk undermining our negotiating position.”

Prime Minister tipped to approve large NHS funding increase

Theresa May is reportedly set to approve a substantial rise in funding for the NHS, as she and Health & Social Care Secretary, Jeremy Hunt, prepare to unveil a new long-term plan and financial settlement for the service. As celebrations for the 70th birthday of the NHS draw near, the Prime Minister appears to have favoured the Hunt’s call for a significant increase, over the more conservative plan put forward by Chancellor, Phillip Hammond.

The Spectator’s report notes that a yearly increase of 3% would ensure an additional £350 million per week for the NHS budget against current levels, thereby meeting the financial pledge made by Vote Leave during the EU referendum campaign in 2016. Hunt, NHS England Chief Executive, Simon Stevens, and a number of independent health policy officials are calling for a rise closer to 4%, or around £5.2 billion per year, in order for the service to meet anticipated demand increases over the course of this parliament.

A report released by the Institute for Fiscal Studies (IFS) and Health Foundation said this necessary funding increase will have to come from tax rises, which could cost British households an extra £2,000 per year. IFS Director, Paul Johnson, said the public now faces a clear choice between “higher taxes and a health and social care system which meets our expectations and improves over time, or taxes at current levels and a more constrained health service delivering less than we have become accustomed to.” Chair of the Health Committee, Sarah Wollaston, said that anything below a 4% increase “would be disastrous”, while claiming that the public would be willing to pay more for an improved service.

If the Spectator report proves to be true, Theresa May will be shortly presenting a popular birthday present to the NHS in the form of the most significant increase in funding since the Coalition Government came to power in 2010. Jeremy Hunt refused to confirm or deny the reports at an Institute for Government event later in the week, but it appears almost certain that the Government will give the NHS additional money well over and above that provided by recent limited top-ups.

The devil will be in the detail: in keeping with Sarah Wollaston’s warning, stakeholders across the sector will be unlikely to ease the pressure on the Government if it presents a figure below that called for by the likes of the King’s Fund, IFS, and Office for National Statistics. However, a 3% year-on-year increase would indeed take funding beyond the £350 million extra-per-week demanded by prominent Brexiteers in 2016 and would represent a considerable victory for the likes of Boris Johnson and Michael Gove in their efforts to present a ‘better Britain’ post-Brexit.

NMC launches new nursing standards

The Nursing and Midwifery Council has launched a new set of standards to ensure the “next generation of nurses will learn… to deliver world class care.” The regulator has also introduced standards for a “more modern and innovative approach” to the training of nurses and midwives by practice partners and universities across the UK. The introduction of these new standards follows a decision taken in March that all future nurses are trained under the same set of procedures, and to provide the same set of communication skills regardless of their particular fields of practice.

Key features of the new standards include: changes to mentoring, to support students better in both practice and academic settings; adoption of the Royal Pharmaceutical Society competency framework for prescribers; and removal medical management standards, which will be replaced by “consistent guidance” applying to all health and social care staff. Chief Executive of the NMC, Jackie Smith, said the new standards “represent a huge leap forward”, and “raise the bar for the next generation of nurses”. The NMC added that nurses will have greater understanding across all four fields of practice, in particular mental health, while also emphasising teamwork and leadership.

Scotland reveals safe health and care staffing standards

The Scottish Government has published a Bill to enforce safe staffing standards across the Scottish health and care system. If passed, the Health and Care (Staffing) (Scotland) Bill will legally require NHS boards and care services to have appropriate numbers of trained staff in place. It would also require the use of the country’s existing workload planning tools to determine what safe staffing levels are.

Scottish First Minister, Nicola Sturgeon, first made the promise for safe staffing legislation in 2016, after Wales became the first UK country to introduce similar legislation. Unlike the draft Bill in Scotland however, Welsh legislation is currently only applies to adult acute medical and surgical inpatient wards.

Scottish Health Minister, Shona Robinson, said the Government was fully aware, stating: “there is a clear link between effective and sustainable staffing levels and high-quality care”, adding that it is “vital we have the right staff in the right place, with the right skills, long into the future.” Peter Bennie, Chair of the British Medical Association in Scotland, said “it has never been more important to have the right mechanisms in place” but argued that “there must also be an acceptance that this bill does nothing to tackle the core issues of recruitment and retention that are such a problem for NHS boards.”

While the safe staffing legislation in Scotland appears almost certain to pass, there have been no serious suggestions at this stage that similar legislation will be enacted in England. Equally, Northern Ireland has not approached the issue in detail, though is of course incumbered from passing any meaningful legislation before a return to power-sharing takes place. A poll of 1,600 UK adults carried out for the RCN in May found that 74% were concerned about nursing staffing levels in the NHS.

GP representation declining as role of CCGs questioned

The GP magazine, Pulse, has obtained figures showing that GP representation on CCG boards continues to decline. The report states that 39% of all board positions are filled by general practitioners, a fall from 49% in 2012 when the Health and Social Care Act set up CCGs, and from 43% in 2014. The statistics, obtained through freedom of information requests, also show that GP representation is significantly higher in London CCGs than in the North, and that only 29% of GPs on the boards are female, despite women making up more than half of the overall GP workforce.

BMA GP Committee Chair, Richard Vautrey, said it had been clear from the beginning that the 2012 changes would fail to make an impact and argued “the idea of it being clinical-led commissioning is clearly not the case”. A spokesperson for NHS England said it was the responsibility of CCG’s to maintain the composition of board members. Meanwhile this week, the Institute for Government and the King’s Fund have published a report on The Lansley Reforms and the role of NHS England in English healthcare five years since the Health and Social Care Act. The report’s author, prominent health journalist, Nick Timmins, argued in a piece for HSJ that the reforms have failed to deliver all three main objectives.

The story about board underrepresentation is significant in so far as it adds to growing frustration with the Lansley reforms, at a point in time where the Government is allegedly considering scrapping parts of the 2012 Health and Social Care Act. Part of the rationale behind forming CCGs was to ensure clinician-led commissioning decisions, with a focus on input from family doctors. However, this has not worked in practice in many ways, as CCGs have faced strict budgetary frameworks, and increased oversight from NHS England and new regional health structures, such as integrated care systems and STPs.

Weekly political news round up – 18th May

May 18, 2018 in News by Whitehouse

Overview

The BBC has reported on the Professional Standards Authority publishing its review into the Nursing and Midwifery Council’s handling of allegations of malpractice by nurses on its register in what has been dubbed the Morecambe Bay maternity scandal. The report ruled that avoidable deaths occurred at the hospital while regulators took too long to act on concerns. 11 babies and one mother died in the nine years between 2004 and 2013. The NMC apologised and its Chief Executive, Jackie Smith, resigned ahead of the report’s publication. Having been in the position for six years, she will step down in July.

The Royal College of Nursing (RCN) had its annual congress this week in which it published a number of reports, including pertinent ones detailed below. The BBC reported on a poll of 1,600 adults in which 74 per cent of respondents are concerned about nurse staffing.

Consultation on UTI guidance launched

Public Health England has launched a consultation on the reference guide for diagnosis of urinary tract infections, and it includes a chapter and flow chart on “Infants or children under 16 years with suspected UTI.” The target audience of the guidance is doctors, nurses and pharmacists and “those giving first point of contact for urinary tract infections covering acute uncomplicated infections” in children and others. The aim is to provide “a simple, effective, economical and empirical approach” to diagnosis and treatment.

The guidance flow chart for children starts with a temperature check and lists other symptoms before determining the correct referral pathway and then details the outcome meaning of recommended tests. It outlines sampling options, how to interpret results, and other diagnostic tests.

The deadline for submissions is 30th May. We are in the process of drafting a response on behalf of the PCF.

Nurses call for investment in specialist children’s nurses

The Royal College of Nursing (RCN) has published a report entitled The Best Start: The Future of Children’s Health – One Year On. Valuing School Nurses and Health Visitors in England, in which it called for more investment in specialist children’s nurses. Its findings show that there is a continued downward trend in health outcomes compared with other countries, further disinvestment in universal services and fragmentation in provision for children and young people.

The RCN highlights reduction in health visitors and school nurses is a particular problem and especially considering the Government’s drive to reduce pressures on acute health care services in favour of primary and community health care services. The report reveals that the health visiting workforce is experiencing significant reductions, with NHS posts falling from 10,309 in October 2015 to 8,275 by January 2018. 81 per cent of health visitors and 70 per cent of school nurses had reported working additional time in their last shift alone.

The RCN concludes that the Government must ensure there is sufficient data collected for necessary monitoring and analysis, that specific support is provided for early and school aged years, and inequalities are addressed “in order to improve child health and thereby, in the longer term, adult population health outcomes.”

Janet Davies, RCN Chief Executive & General Secretary, said: “Children’s health services are the frontline defence against childhood obesity and poor child mental health. This downward trend cannot continue. The Government risks turning back the clock on children’s health if it does not invest in the school nursing and health visitor workforce.”

Councils reallocate school funding for SEND provisions

The Independent has reported that councils across England are being compelled to reallocate funding for state schooling to pay for dedicated special educational needs provisions in order to compensate for yearly overspend elsewhere. Some Leaders of county councils have penned a letter to the Education Secretary, Damian Hinds, on the matter, following the County Councils Network publishing results of a survey which shows eight authorities have transferred £43 million of money allocated to schools to SEND provisions over the past four years. 21 county councils have overspent on their allocation of the £130 million high needs block government grant.

Angela Rayner MP, Labour’s Shadow Education Secretary, said that “Schools should not have to choose between funding extra support for children with special educational needs and providing the basics that every child deserves in the classroom, but that has been a result of this government’s cuts. The Education Secretary and the Chancellor promised every school a cash boost to their budget, but now they have abandoned their own guarantee. Schools have been left scrambling to fill the gaps in their budgets, with more cuts the inevitable consequence of their failure to give them the resources they need.”

A Department for Education (DfE) spokesperson said: “Thanks to our reforms and the hard work of teachers 1.9 million more pupils are in good or outstanding schools than in 2010. By 2020, core school funding will rise to a record £43.5 billion – its highest ever level and 50 per cent more per pupil in real terms than in 2000 – and the introduction of the National Funding Formula will address historic disparities in the system. The high needs budget for pupils with special educational needs is £6 billion this year – the highest on record. Thanks to the additional £1.3 billion funding announced last year, every local authority will see an increase in their high needs funding over the next two years.”

Nurses denied training because of “staffing and funding pressures”

The Royal College of Nurses (RCN) has published a report saying that nursing staff are missing out on training amid NHS cuts and attributes it to a combination of winter pressures, staff shortages and funding cuts. Workforce development funding in England has reduced by 60 per cent in two years by Health Education England, and stood at £83.49 million in 2017.

The Nursing Times has reported on an unpublished RCN survey which suggests that 14 per cent of nurses in England, along with 35 per cent in Wales, 27 per cent in Scotland and 24 per cent in Northern Ireland have been unable to complete mandatory training, ranging from hand hygiene to blood transfusion processes.

The report warned that this could result in staff falling behind with the latest clinical developments thereby putting patient safety at risk and potentially disqualifying nurses from the Nursing and Midwifery Council’s (NMC) register. The NMC’s revalidation requirements currently require nurses to complete 35 hours of continued professional development training every three years, on top of which the NMC is introducing new education standards for pre-registration students from January 2019.

The College is subsequently calling for additional ringfenced funding for nurse CPD, for all bodies working in healthcare education and development to publish data on total funding allocations for CPD and training, and for employers to be compelled to set aside time for it.

RCN Chief Executive and General Secretary, Janet Davies, said: “Nurses make up half the NHS workforce and, as a society, we cannot afford for their training to be an optional extra. These short-sighted cuts must be reversed. For the sake of patient safety, nurses must be allowed to keep up-to-date with developments and advance into tomorrow’s nurse leadership positions. Policymakers and employers must find a way to fund and guarantee this time. Nurses must not be allowed to fall foul of the regulator’s requirement,”

A Department of Health and Social Care spokesman said: “The NHS would collapse without our wonderful nurses – the fact that the NHS is ranked as the safest healthcare system in the world is a testament to their skill and dedication. It’s essential that individual NHS employers – who remain responsible for funding this specific type of training – support staff to develop and grow their skills, so that they can meet the requirements of their role.”

Weekly political news round up – 11th May

May 11, 2018 in News by Whitehouse

Overview

The Daily Mail has reported on NHS England’s decision to prohibit the prescription of medicines that can be bought over the counter and treat infrequent and not serious ailments, highlighting that it comes into effect at the end of the month. The title highlights specifically that laxatives “will no longer be available on NHS prescription at the end of the month” and in the article references medicine for constipation as well. It makes no reference to child medicines.  The PCF responded to this consultation, which does contain the concession “laxatives are not recommended for children unless they are prescribed by GP”.

Health Minister answers questions on children’s continence care

The Labour MP for Bristol West and Opposition Whip, Thangam Debbonaire, has had her questions on children’s continence answered by Health Minister Steve Brine. Ms Debbonaire asked what assessment the Department for Health and Social Care “has made of the availability of Level 1 paediatric continence services for (a) school nurses, (b) health visitors and (c) GPs to provide preventative early treatment for (i) bladder and (ii) bowel problems in children.”

Mr Brine said: “Clinical commissioning groups (CCGs) are responsible for commissioning continence services and work with local partners to ensure the appropriate level of services are provided dependent upon local need. CCGs may choose to commission the health visiting and school nursing service to deliver continence services. Public Health England (PHE) has developed commissioning guidance to support local public health delivery; the guidance also clarifies the commissioning responsibilities for continence services. Further information is available here: https://www.gov.uk/government/publications/healthy-child-programme-0-to-19-health-visitor-and-school-nurse-commissioning Continence services are not included in the public health grant and PHE has not undertaken a national assessment of continence services.”

Ms Debbonaire asked what assessment the Department has made “of the effect on paediatric continence services of the transfer of public health commissioning responsibilities from NHS England to local authorities in 2015.” Mr Brine said that the Department had not made such an assessment.

Regarding continence care guidelines, Ms Debbonaire asked what steps the Department is taking “to monitor the implementation of NHS England’s Excellence in Continence Care guidelines.” Mr Brine said: “NHS England published the Excellence in Continence Care guidance in 2015 in order to help support best practice in continence care, and the Department would expect local commissioners to both draw on the guidance and monitor progress in improving continence care.”

Finally, Ms Debbonaire asked what assessment the Department has made of “of the effect of the Paediatric Continence Commissioning Guide published in 2014 and accredited by NICE.” Mr Brine said: “No national assessment of the effect of the guidance has been made. The Paediatric Continence Commissioning Guide sets out a clear set of specifications for commissioners to follow, including for paediatric incontinence services. The Department expects local commissioners to draw on the guide in commissioning services and to keep their incontinence services under review.”

Thangam Debbonaire tabled these parliamentary questions following engagement with PCF Chair, Dr Penny Dobson MBE. While these answers do not provide the PCF with any new information, they can be used to inform our engagement with parliamentarians and with the Department of Health and Social Care going forward.

MPs brand Govt’s plans for paediatric mental healthcare inadequate

The Education and Health and Social Care Select Committees have published their review of the Government’s Green Paper on Child and Adolescent Mental Health which they considers to be “failing a generation.” The report considers the plans to raise “the very real prospect of hundreds of thousands of children missing out on getting the help they so desperately need.” It notes that the proposals put “more pressure on the teaching workforce without sufficient resources.” It is estimated that 10 per cent of children and young people suffer from a mental health condition and although the number of children and young people seeking NHS care has significantly increased over the last 10 years, Public Health England have admitted that only a quarter of receive the help they need.

The Government’s proposals include encouraging every school and college to have a designated senior mental health lead; setting up mental health support teams to work in schools; and piloting a four-week waiting time for NHS mental health services. It pledged to offer every primary and secondary school in England mental health awareness training, and for mental health and wellbeing to be taught as part of PSHE. The Paper aims to result in one in four schools offering the provision by 2022. The Government pledged over £300m to achieving the proposals, including £95m for school to appoint and train the leads from 2019 and will be responsible for coordinating support between schools, specialist therapies and the NHS. £215m has been pledged to the support teams, which will work with the NHS to offer and support treatment in schools.

Dr Sarah Wollaston, Chair of the Health and Social Care Committee, called for services to be joined up “in a way which places children and young people at their heart and that improves services to all children rather than a minority”. Robert Halfon, Chair of the Education Committee, called for urgent action by Government “to address the mental health issues which children and young people face today.”

Mary Bousted, the Joint General Secretary of the National Education Union, agreed with the report, saying: “The crisis in child mental health provision will not be ‘transformed’ by the unambitious proposals in the government’s green paper. A government that’s complacent about child poverty and relaxed about excessive testing in schools can’t claim to care about young people’s mental health.”

This report further highlights the extent to which Government policy often leads to what has been dubbed a postcode lottery in health and education provisions, as the PCF has determined is the case with continence care through its FOI project. We will continue to make the case for this to be addressed in our engagement with Parliamentarians and civil servants.

Government announces support for children with additional needs

The Department for Education has launched new measures aimed to support children with special educational needs as part of “the government’s drive to give every child the tools to fulfil their potential” and the Early Years Workforce Strategy. This comes as the Government is migrating Statements for children and young people with Special Educational Needs (SEN) into Education, Health and Care (EHC) plans. The new measures include a £20 million contract with the Council for Disabled Children and Contact “to provide families and young people with SEND with impartial advice, support and information;” and a SEND school workforce contract with University College London.

Data published alongside the announcement show that over 98 per cent of SEN Statements  were assessed by the deadline of 31st March. This means that 3,873 statements were not assessed by the deadline. Data from a month beforehand shows that decisions were made on 10,432 statements by Government in one month, because on 1st March 14,305 statements were yet to be assessed. Ofsted has said that the quality of the plans vary widely between different geographical areas, and even plans completed on time often had “too much confusing terminology and jargon.”

Children’s Minister, Nadhim Zahawi, said “We want every child to have the support they need to unlock their potential, no matter what challenges they face. Today’s data shows that almost all of SEN statements were reviewed on time, which is testament to the hard work of councils their partners and families all over the country to give children and young people with Special Educational Needs and Disabilities (SEND) the support they deserve.”

This indicates that there is increasing collaboration between the Department for Education and the Department for Health and Social Care. The PCF will draft a letter to Mr Zahawi introducing the Forum and requesting a meeting.

Hammond and Hunt in battle over NHS funding boost

The Guardian has reported on a dispute between Health and Social Care Secretary Jeremy Hunt, and Chancellor of the Exchequer, Philip Hammond, over how much money the NHS should be allocated in the long-term funding deal currently being negotiated. Both Secretaries of State are competing for Prime Minister Theresa May’s support in negotiations after she voiced her support for giving the NHS 10-year funding cycle to help it better plan long-term. Hunt is calling a four per cent a year budget increase for the NHS, which is the equivalent of £5.2bn a year, with Hammond suggesting a more modest 2.5 per cent increase, the equivalent of £3.25bn a year. This is significantly more money than the Government has committed to date, which equates to a 0.7 per cent increase on the year of £800 million, increasing the budget from £126.4bn to £127.2bn a year.

Key health figures have supported Hunt in calling for a four per cent increase, including NHS Chief Executive, Simon Stevens, numerous royal medical colleges, the Office for Budget Responsibility and the Institute for Fiscal Studies, who believe that the additional investment will go a long way to solving the NHS’s crisis. Hunt is also supported by Defra Secretary, Michael Gove, and Foreign Secretary, Boris Johnson, who both supported the claim by Vote Leave that funding currently channelled to the EU could be diverted to the NHS after Brexit. May is expected to use the celebrations around the NHS’s 70th birthday in July to announce an increase in funding.

Director of Policy at health think tank the Kings Fund, Richard Murray, said that anything less than a three per cent annual rise would hasten the NHS’s deterioration, adding: “Standards of care will fall and patients and their families will pay the price. We have to remember that we are in the longest funding squeeze in the NHS’s history and cracks are beginning to show across the service.”

Minister ‘misinformed’ over learning disability mortality report

HSJ has reported that Care Minister, Caroline Dinenage, has admitted that she misinformed MPs when answering an Urgent Question in the Commons this week. Dinenage had said that the Department for Health and Social Care had not known that the Learning and Disabilities Mortality Review Programme’s first annual review would be published on 4th May when in fact the Department had been “informally notified” of its publication the day before it came out. The University of Bristol had been commissioned by NHS England to produce the report.

Labour MP for Worsley and Eccles South and Shadow Health Minister, Barbara Keeley, had asked why the review was published the day after the local council elections, during parliamentary recess and before the bank holiday, considering that gave “members little chance to scrutinise its findings.”  Labour MP for Heywood and Middleton and Shadow Foreign Minister, Liz McInnes, noted that the front page of the report stated “December 2017.”

In a letter acknowledging her mistake, Dinenage said: “Firstly, after the urgent question, I was informed NHS England had discussed the timing of the publication and agreed the date with the University of Bristol. Secondly, I have also learned that the Department was informally notified of the publication by NHS England on Thursday 3 May. It remains the case the Department was not officially notified about the timing of the publication of this report, and it did not have any say in the timing of its publication.” A spokesperson from the University of Bristol said that “Contrary to what the minister has said, the University of Bristol had no say on when the report was published.”

Keeley responded that, regardless of the apology, the Government and NHS England had tried to bury the findings of the report, which found that fewer than one in ten of the 1,311 deaths between July 2016 and November 2017 had been reviewed. She said: “The report cites a lack of local capacity, inadequate training for people completing mortality reviews and staff not having enough time away from their duties in order to complete a review. If there are issues around capacity and training we would like to know what NHS England is doing to rectify this.”

Weekly political news round up – 4th May 2018

May 4, 2018 in News by Whitehouse

Overview

Local elections took place across the country this week. The top line analysis is that the three major parties benefitted from a significant collapse in the UKIP vote. UKIP lost 103 councillors, reducing the Party to just two councillors overall. Labour failed to win new councils in London and did not achieve the results some were expecting in the run-up to the local elections, fuelling comments that the peak of Jeremy Corbyn’s popularity has passed. Jeremy Corbyn said the Party had achieved a “solid set of results” highlighting that Labour has won 45 seats across England in places which it has never held before. Conservative Secretary of State for International Trade Liam Fox said the Tories’ results had been at the “higher end of expectations.”

The Tories performed well in areas with a substantial leave vote in the 2016 referendum, where they picked up a considerable number of votes from UKIP; while Labour performed well in places where the remain vote was stronger and with a higher proportion of younger voters. Labour failed to gain a single council in London, having targeted Wandsworth, Westminster, and Barnet, the latter of which is being attributed to anti-Semitism in the Party and the high number of Jewish voters in the area. Meanwhile outside of the capital, Labour lost control of Derby. Bedworth In Warwickshire and Nuneaton but did win back Plymouth and became the largest party in Trafford.

The Liberal Democrats had a positive night, regaining control of Richmond in London from the Tories and gaining seats elsewhere.  The Conservative vote is up by 13 points where more than 60% backed leave but down by one point in areas where less than 45% voted leave. The Conservative Party also struggled in places with where there were more graduates and people from an ethnic minority background.

Government publishes plans for Nursing Associates in England

The Government has published the outcome of its consultation on expanding the Nursing and Midwifery Council’s (NMC) governing legislation – the Nursing and Midwifery Order 2001 – to grant the NMC the legal power to regulate the nursing associate profession in England. The intention of this change is to ensure that associate nurses – a new role in healthcare – are held to the same standards and granted the same safeguards as nurses and midwives, “except where it is necessary to accommodate specific differences in the nursing associate profession.”

In announcing that it would implement the proposals, the Department of Health and Social Care said that it had “broad support” from industry. Going forward, the NMC will register, set standards, approve training programmes for, and carry out fitness-to-practice activities on associate nurses. Nursing associates training through a programme not approved by the NMC will be able to join the register up until July 2019, after which point they must be on an NMC-approved course. NMC inspections will be carried out by nurses until the associate nursing profession matures and there are enough qualified nursing associates in the role to manage it. Nursing associates will not be able to prescribe even on a temporary basis such as in times of national emergency.

In England, it will be an offence for someone to call themselves a nursing associate unless they are registered with the NMC and hold the requisite qualifications; while those with comparable qualifications from the devolved nations will be able to be put on the register. The Government noted that many of the respondents to the consultation called for this measure to be applied across the UK. The Government has not done this because nursing associates are not prevalent outside of England and such an offence comes under other crimes, such as fraud in Scotland.

State-Enrolled Nurses (SENs) will no longer be able to join the NMC register, although existing registrants will be able to remain on it. UK-trained SENS have been unable to register since the late 1990s and there are currently only 11,000 are currently on the SEN register, with “this number diminishing each year.” In future applicants from outside the UK will be directed to the associate nursing or sub-part 1 of the register.

NMC Chief Executive and Registrar Jackie Smith said: “Since our council agreed to become the regulator for nursing associates we’ve been working hard to make sure everything is ready to welcome the first nursing associates on to our register in January 2019. It’s clear that there’s widespread support for the proposed approach to regulation and while there’s still more work to be done, today is an important landmark. It’s critical that the government now push forward with these changes to enable us to open the nursing associate part of the register on time.”

The NMC is currently consulting on the standards to which they will hold nursing associates, as well as the content of training programmes. The PCF is compiling a response ahead of the submission deadline on 2nd July.

Technical issues result in 450,000 women denied breast cancer screening

Health and Social Care Secretary Jeremy Hunt revealed this week that technical difficulties in the NHS had resulted in 450,000 women not being called to breast cancer checks, The Times reported. It has been estimated that this caused up to 270 premature deaths. The technical difficulties have gone undetected for nine years and were only identified in January of this year following a modernisation of the computer systems used. This is despite several separate concerns being raised previously. Public Health England and the NHS are blaming one another for the problem, as NHS England has responsibility for spending but does not run the 79 hospitals that provide breast cancer screening; while Public Health England has responsibility for preventative strategies but does not provide services. Both organisations manage the computer system.

Hitachi, which manages the computer system, attributed the concerns to a local issue that had been resolved when Public Health England’s regional teams investigated the concerns last year, which were raised by hospitals in London and the West Midlands, following women at the age of 70 not being invited to checks, despite that being policy.

Baroness Morgan of Drefelin, Chief Executive of the charity Breast Cancer Now, said: “We urgently need to understand why quality-assurance measures did not pick this up and what procedures will be put in place to ensure such a colossal mistake is never repeated.” Shadow Health Secretary Jonathan Ashworth said: “It seems extra-ordinary that while breast cancer screening rates were falling, serious questions were not being asked, especially as we are now hearing reports of GPs warning of missed tests.”

Ministers have also been urged to provide assurances that bowel and cervical cancer screenings were not affected, after former Conservative Health Secretary Andrew Lansley blamed health cuts for his own bowel cancer going undetected until it reached stage 4.

The Lancet finds child mortality rate one and a half times higher than Sweden

The Lancet has published a comparative study of child mortality rates in England and Sweden, to look into the extent to which “adverse birth characteristics and socioeconomic factors” determine the difference between child mortality in Sweden to that of England, where it is “almost twice as high.” It found that the difference is “largely explained” by England’s relatively “unfavourable distribution of birth characteristics” which could be countered most successfully by improving the health of women before and during pregnancy. Socioeconomic factors were found to have more of an impact after one month of age.

Dr Ronny Cheung from the Royal College of Paediatrics and Child Health (RCPCH) responded to the study saying, “At a time where public health budgets are being cut, the very services that are required to help improve these rates are being lost. We need a commitment from Government that health visiting services will be protected – helping professionals support mothers at risk of ill physical and mental health, in addition to providing stop smoking services, breastfeeding support and weight management advice to those at-risk groups.”