Weekly political news round up – 29th June

June 29, 2018 in News by Whitehouse

Overview

NHS England’s Chief Executive, Simon Stevens, has said that the NHS has “an enormous responsibility” to be financially responsible following the Government’s announcement of a 3.4 per cent annual funding increase for the Health Service over the next five years, breaking with the Government’s eight-year programme of austerity. It is important that the PCF raises awareness of the long-term cost savings of implementing paediatric continence provisions throughout England where the funding applies.

Shadow Health Secretary, Jonathan Ashworth, has said that the funding announcement, which falls short of the health sector’s claim that it requires four per cent just to maintain current performance, is not enough to tackle the NHS crisis in the midst of increasing demand coming from an aging population.

MPs debate toilet provision and accessibility

Labour MP for Dewsbury and Shadow Minister for Mental Health, Paula Sherriff, has moved a Bill in the Commons Chamber on Toilets (Provisions and Accessibility), calling for certain buildings to have “Changing Places,” toilets which are accessible to “people with complex needs” such as a height-adjustable, adult-sized changing bench, a tracking hoist system or mobile hoist, and adequate space for a disabled person to have two carers, a centrally placed toilet with room either side, a screen or curtain for privacy, a wide tear-off paper roll to cover the bench, a large waste bin for disposable pads, and a non-slip floor. Changing Places are currently recommended for some buildings; this Bill would make them mandatory for “large new builds, complexes with public access, or sites where visitors can reasonably be expected to spend long periods of time.”

The UK’s 1,123 Changing Places are disproportionately concentrated in large cities and there are some areas which do not have such facilities within 100 miles. Sherriff asserted that over a quarter of a million people cannot use standard accessible toilets in the UK, including 30,000 people with cerebral palsy, as well as 40,000 people with profound and multiple disabilities, and 10s of thousands of people with other complex needs. She noted that “the number of people with complex disabilities is growing” as technology advances and saves people’s lives and people live longer and said the extent to which lack of facilities prohibits people from going out is “a sad reflection on our society’s priorities.” It can result in disabled people “facing the indignity of being changed on the dirty floors of public toilets,” people staying at home and social isolation.

This Bill will be read for a Second time on Friday 23rd November.

We will reach out to Sherriff inviting her to meet with the PCF so we can introduce the Forum and its campaigns and invite her to support us going forward.

Driver Youth Trust launches SEND Governance Review Guide

The Department for Education has collaborated with literacy charity Driver Youth Trust and Whole School SEND, a consortium of SEND campaigners, to launch a SEND Governance Review Guide which sets out a framework for how to ensure that learners with SEND access high-quality provision. When publishing the Guide, Driver Youth Trusts Chief Executive, Chris Rossiter, highlighted in TES that SEND children have the poorest academic outcomes of any demographic, with only 18 per cent of Key Stage 2 children with SEND meeting the expected standards in the three Rs in 2017, compared with 70 per cent of non-SEND children. The Guide provides advice for mainstream and special schools on how to ensure they meet their obligations in a financially strained environment.

The Guide sets out the features of governance which provides a basis on which boards can effectively and confidently discharge their duties with regards to offering high quality SEND provisions: strategic leadership, accountability, compliance, structure and processes, people management, and evaluation. The Guide lists potential next steps following a review; boards could create an action plan in line with existing strategic plans to keep up to date; a review of policies to ensure they are compliant and sufficiently signposted; active engagement in peer reviews, and engaging the expertise of a National Leader of Governance.

NHS performance below that of international peers

The NHS at 70: How Good is the NHS? is one report in a series conducted by researchers from the Health Foundation, the Institute for Fiscal Studies, the King’s Fund, and the Nuffield Trust and commissioned by the BBC for the NHS’s 70th birthday. It compares the NHS with its international peers in five key areas: the relative strengths and weaknesses of the health service, the state of social care, NHS funding, the public’s expectations of the NHS and the potential of technology to change things in future. The report is an analysis of OECD data across 18 similar developed countries: Australia, Austria, Belgium, Canada, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Japan, Netherlands, New Zealand, Portugal, Spain, Sweden, and the USA. It pays particular attention was paid to the speed and accessibility of care, the efficiency of the system, and the outcomes delivered for patients.

The report found that the most notable strengths of the NHS included “unusually good financial protection to the public from the consequences of ill health.” The NHS had the lowest proportion of those countries examined of people skipping medicine due to cost; in 2016 2.3 per cent of patients did so compared with the average of 7.2 per cent. Despite media coverage, the NHS is relatively efficient, with the largest share of generic prescribing, at 84 per cent compared with the international average of 50 per cent. It spends less on administrative and managerial costs than most of the comparators, and it is particularly doing well at managing patients with long-term conditions out of hospital. A&E waiting times and waiting times for hip operations are average, again despite media criticism and deteriorating rates in recent years.

The NHS’s weaknesses, as identified by the report, include poor treatment of eight of the 12 most common causes of death, such as in the 30 days after a heart attack and within five years of being diagnosed with breast cancer, rectal cancer, colon cancer, pancreatic cancer and lung cancer, although it has started to improve in recent years. It is the third worst performer in managing amenable (i.e. preventable) mortality. It has an above average perinatal and neonatal mortality rate, standing at seven in 1,000 compared with the average of 5.5 in comparator countries.

Commentators have noted that the NHS performs this well despite having lower than average numbers of all types of staff besides midwives. It has one doctor for every 356 people, compared with the average of comparator countries of a doctor for every 277 people. The NHS has the lowest number of MRI and CT scanners per patient of all the systems considered.

Nigel Edwards, Chief Executive of the Nuffield Trust, referred to media coverage of NHS performance saying that “Discussion about the NHS is often marked by an unhelpful degree of exaggeration” while noting that the NHS is run “with very scarce resources” and achieves “poor outcomes in some vital areas like cancer survival.” Paul Johnson, Director of the Institute for Fiscal Studies, said that while “access is good and people are protected from high costs […] too many people in the UK die when good medical care could have saved their lives.” Dr Jennifer Dixon, Chief Executive of the Health Foundation said that “austerity has bitten hard, and the lag of investment shows.”

Weekly political news round up – 22nd June

June 22, 2018 in News by Whitehouse

Overview

This week the controversial EU (Withdrawal) Bill, which aims to transfer EU law into UK law once the UK leaves the EU, has been adopted by the UK Parliament. The Bill entered the so-called “ping pong” phase, where amendments to a Bill move back and forth between the House of Commons and the House of Lords. After Peers had retabled an amendment giving Parliament a “meaningful vote” if the Government fails to reach a Brexit deal, MPs rejected it by 319 to 303.

The Government fought off a rebellion within own party ranks by promising that an official ministerial statement would be issued making clear it is ultimately for the House of Commons Speaker to decide whether MPs get a “meaningful vote”. While the concession was accepted by pro-EU Conservative Dominic Grieve, who drafted the amendment, six other Conservative rebels still voted in favour. On the Labour side, four MPs defied their whips and sided with Government.

Both sides have claimed victory with pro-EU MPs saying that the Parliament will have a say on what happens if negotiators fail to get a deal.  International Trade Secretary Liam Fox, meanwhile, said nothing had really changed and the option of a no-deal Brexit was still on the table.  The Bill now waits for the final stage of Royal Assent when it will become law.

May announces major NHS funding boost

The Prime Minister, Theresa May, has announced that she will increase NHS funding by 3.4 per cent, the equivalent of £20bn over four years, as part of plans to implement a long-term NHS funding package to coincide with the NHS’s 70th birthday celebrations. The announcement comes after eight consecutive years of one per cent annual funding increases, the longest period of constrained funding growth in the history of the health service. During this period, conditions in the NHS are widely considered to have deteriorated, with increases in demand outpacing additional funding. May has said that, in return for the extra money, the NHS must create and deliver a 10-year plan with improvements in services, particularly focusing on A&E waiting times, cancer survival rates and mental health provision. She said that the additional funding cannot be “wasted… on bureaucracy.”

This 3.4 per cent increase remains below the 3.7 percent average annual increase in NHS funding since its creation in 1948 and has come amid intense pressure from key figures in the sector who have argued the NHS needs at least a 4 per cent annual increase in order to maintain its current levels of service delivery. Support for the 4 per cent increase comes from NHS England Chief Executive, Simon Stevens, and prominent health think tanks – the King’s Fund, Nuffield Trust, and the Health Foundation – among others.

Jeremy Hunt’s recent calls for increased NHS spending have been supported by a handful of Cabinet allies and other influential non-party organisations, including the Institute for Fiscal Studies and the Office for Budgetary Responsibility. Major stakeholders have welcomed the announcement admitting it is more than they had anticipated. The King’s Fund Chief Executive, Chris Ham, responded saying, “ While we welcome the Prime Minister’s assurance that future decisions about social care spending will not add to pressures on the NHS, this hardly suggests an ambitious statement of intent.”

This is a bold move by the Prime Minister considering the pressure currently being placed on her and her Chancellor, Philip Hammond for increased funding from several other government departments. The Treasury is eager to keep costs down in the wider context of a low value for the pound, and uninspiring economic growth. Where the increased funding will come from has been subject to debate (as detailed below) but the increase is widely expected to be sourced through a combination of increased taxes (with a specific ‘hypothecated’ NHS tax unlikely to be used), increased government borrowing and a “Brexit dividend.”

Critics have highlighted the lack of costings for the plan as the source of £11bn of the £20bn package has yet to be determined. Health and Social Care Secretary, Jeremy Hunt, suggested that “exact details” of how the increase would be funded “will be announced in the budget” in November, while hinting that the pot will be funded via a combination of additional government borrowing and tax rises.

It is believed that borrowing could account for £8-10bn, while the Times is reporting that initiatives such as a freeze of personal allowance and national insurance thresholds at the end of parliament could generate £4bn, although increasing taxes or debt may be met with strong resistance from within the Conservative Party whose core base support has traditionally supported low tax models. It is also rumoured that the Government will cancel planned reductions to corporation tax, despite these being strongly supported by Chancellor Philip Hammond.

Theresa May has referred to a “Brexit Dividend” as one source of funding. This refers to the Vote Leave campaign’s controversial claim that leaving the EU could free up £350 million a week for additional investment in the NHS. Critics roundly dismissed this claim, but the total funding announced exceeds the pledge by committing £394 million a week between now and 2023. Critics have noted that the money saved from not being in the EU will not be available within the relevant time period, given the UK has provisionally agreed to a transition period until 2021 and will probably be making substantial contributions towards the EU Budget long after that. Health Select Committee Chair and Conservative MP, Dr Sarah Wollaston, called the reference to a Brexit dividend “tosh”, whilst Labour’s Shadow Chancellor, John McDonnell, described it as “not credible”.

The Prime Minister also reiterated her commitment for a tangible new 10-year plan for the NHS, promising ‘more doctors’ and ‘more nurses’, but reports from the Institute for Policy Research said that whilst the proposed increase in NHS funding was ‘very welcome’, it ‘must be accompanied by a serious plan for reform’, with a ‘shift from diagnose and treat to predict and prevent’.

This comes after polling by the NHS Confederation found that 77 per cent of people support a four per cent increase in health spending over the next 15 years, and 82 per cent supported a 3.9 per cent increase in social care funding. This would increase the NHS budget from its current £128bn to £234bn by 2033.

This announcement presents an opportunity for the PCF as it can help the Department for Health and Social Care (DHSC) achieve its policy aims of providing healthcare that is longer-sighted and more preventative than it has not been as empowered to pursue until now. The PCF’s asks fit well within the demands placed on the NHS; we will look to engage with policymakers to ensure that its voice is heard.

This announcement suggests that the Government, weakened by divisions on Brexit, is backing down on positions it once firmly– keeping taxes low and tackling immigration – in order to gain credibility on its management of the NHS, something Prime Minister, Theresa May, has acknowledged as a weakness for the Conservative Party. The fiscally conservative nature of Chancellor, Philip Hammond, has manifested in his assertion that the break with policies of austerity in DHSC will not mean other departments will receive an increase in funding to fill their budget shortfalls.

The Prime Minister’s reference to a “Brexit dividend” was seen by some as a calculated ploy to gain leverage with Brexiteers ahead of her requests for a series of compromises on the EU Withdrawal Bill and Brexit negotiations. However, the announcement signifies a tangible break with years of Conservative Party commitment to austerity, while offering a clear indication that the Prime Minister has overruled her Chancellor, Philip Hammond, who had suggested a more modest increase in NHS spending.

The 3.4 per cent funding rise will not please everyone, with respected figures across the health service claiming between 4 and 5 per cent is needed. Additionally, a verdict on this pledge may not be reached until the budget announcement in November, when the precise source of the funding has been revealed: a reduction in personal allowance will entice the Labour opposition to criticise May for punishing the working poor, while any revision to corporation tax cuts will infuriate the right of the Conservative Party and many grassroots activists. 

In the short-medium term, May’s nod to the Leave Vote pledge and significant cash boost for the NHS should ease some of the internal and external pressure on the Prime Minister’s position. She will also be applauded by less-partisan figures in the NHS who will look forward to the most significant funding boost for the best part of a decade.

World Continence week marked across the world

This week marked World Continence Week which saw stakeholders including the PCF and its constituent members getting involved. The Association for Continence Advice (ACA) has published posters to help raise awareness for the occasion. The PCF invited people to visit its website this World Continence Week, promoted by ERIC, and Essity and Coloplast promoted their recent reports relating to paediatric continence issues.

The International Continence Society (ICS) outlined the history of World Continence Week, which started in Cairo in 2008 and its aims to break the “taboo” around continence issues which it estimates results in over 60 per cent of people with continence issues refraining from getting help. The ICS advertised related events including a Toilet Training Including Children with Additional Needs in July and ERIC’s Paediatric Continence Care Conference in October.

The ICS outlines the vision of World Continence Week being:

  • Globally facilitate continence awareness and promotion to improve health, wellness and quality of life.
  • Provide a reputable forum for those seeking information on Continence Promotion and therapies.
  • Create a worldwide network of events and organisations that will be recognised as leading authorities of Continence and Bladder and Bowel Health information.
  • Further establish Continence Awareness and promote a multi-disciplinary approach to treatment.

The World Federation of Incontinence Patients (WFIP) tweeted regularly in the run up to World Continence Week, supported by Medtronic UK and Ireland who have published an infographic on adult continence issues, their prevalence and what can be done to help. How to Potty Train has shared its potty-training expertise for the occasion.

The PCF will continue to engage with World Continence Week and collaborate with stakeholders to raise awareness of paediatric continence among the public and policymakers.

Australia uses toilet humour to tackle continence issues

Australian Health Minister Ken Wyatt, who launched World Continence Week in Australia, has publicly encouraged the one in four Australians who are affected by continence issues to seek help so that they can “laugh without leaking” and “live life to the full.” The Australian Government has provided over 14 million Australian Dollars since 2016 to “ensure all Australians have access to the information and support they ned to get help for continence problems.”

Chief Executive of the Continence Foundation in Australia, Rowan Cockerell, said that only 30 per cent of people with a problem seek help because of the stigma attached to the condition. He highlighted that “even children” are affected by this. Australia which is leading the way in terms of many continence provisions, had over 200 events related to World Continence Week.

Weekly political news round up – 15th June

June 15, 2018 in News by Whitehouse

Overview

PCF Chair Penny Dobson has been published in the Nursing Times (detailed below) in which she raises awareness of the children and young people with continence difficulties and the work the PCF does to address it.

This week, the EU (Withdrawal) Bill, the Government’s flagship piece of Brexit legislation, returned to the House of Commons from the House of Lords. In a relative success for the Government, the Commons rejected 14 of the 15 amendments that peers added to the Bill.

Theresa May will be relieved that the Commons rejected an amendment that would give MPs a “meaningful vote” on the final Brexit deal; however, to achieve this, the Prime Minister is reported to have promised backbench MPs plans that would give Parliament more power to block a no-deal Brexit. To assure the support of some 17 pro-remain Conservative MPs to reject the amendment after hours of negotiation, May, agreed to submit her own Government amendment to ensure that MPs are given greater powers to prevent a no-deal Brexit. In the end, all Conservative MPs with the exception of Ken Clarke and Anna Soubry voted with the Government.

PCF Chair published in Nursing Times

The Chair of the PCF, Dr Penny Dobson MBE, has written an article for the Nursing Times highlighting the plight of the 900,000 children and young people experiencing continence difficulties in the UK, and the work of the PCF in addressing it. The article outlines the findings from the PCF’ FOI audit carried out in 2017 compared with previous years, showing that only 41 percent of CCGs and health boards provided comprehensive and integrated community-based paediatric continence treatment services, and only 15 percent of local authorities provided a continence service following the transfer of school nurses and health visitors to local authority control.

Penny highlights that an unintended consequence of this poor provision is more children going to A&E and being admitted to hospital for advanced constipation and urinary tract infections, undermining the Government’s pledge to bring more healthcare into the community, which is cheaper for the NHS and less disruptive for the patient.

The article highlights the NICE-accredited Paediatric Continence Commissioning Guide which was published by the PCF in 2015 and is being updated this year, which provides advice for setting up “community-based, integrated and cost-efficient paediatric continence services.” It notes that it is encouraging that 64 percent of CCGs have heard of the Guide and 50 percent are using it. The article also brings the reader’s attention to NHS England’s Excellence in Continence Care guide, an updated version of which is due to be published soon.

This is an articulate and informative piece by Penny and is very positive and wide-reaching coverage promoting the PCF and its asks. Many health providers read the Nursing Times regularly and so will. The article includes contact details for anyone wanting more information; we will keep members updated with any interest expressed. Now that this has been published, we can also seek to published the results of the FOI audit on the PCF website and will continue to campaign to have them published on Public Health England’s Fingertips tool.

Welsh Government launches action plan for health and social care

The Welsh Government has published its action plan for “A Healthier Wales: health and social care” in which it outlines how the Welsh Government intends to promote healthy living and provide for those who need health and social care. It aims to support people to “stay well, not just treat them when they become ill;” improve the technology used in healthcare to improve the patient and staff experience; provide support to patients’ loved ones as part of a “person-centred” approach; and deliver more care in the community, supporting the NHS’s aims more broadly to take pressure of hospitals, save money and be less disruptive to the patient.

The plan outlines five main objectives: integrating health and social care services; shift services out of hospitals and into communities; improve how it measures “what really matters” such as early detection; making health and social care in Wales a “great place to work;” and encourage collaborative working. This will be funded in part by the UK government and the Welsh Government will consult on how to generate the extra revenue required. It outlines children and young people as a key demographic to improve provisions for.

This action plan is consistent with the policy aims of the NHS broadly. The PCF will engage with key stakeholders in the Welsh Assembly to highlight the extent to which continence services in the community save the NHS money and young people the distress of experiencing continence issues unsupported.

May poised to boost NHS budget by billions

Prime Minister Theresa May is expected to announce that she will increase NHS funding by between three and four percent, the equivalent of £20bn over four years, as part of plans to implement a long-term NHS funding plan and to coincide with the NHS’s 70th birthday celebrations. This comes after eight years of a one percent annual funding increase limit, the longest period of constrained funding growth in its history. In that time conditions in the NHS have been deteriorating as increases in demand have been outpacing increases in funding.

Those working in the health space have mounted intense pressure on the Government to increase funding by four percent to keep the NHS going, including NHS England Chief Executive Simon Stevens, health think tanks the King’s Fund, Nuffield Trust, and the Health Foundation, economics bodies such as the Institute for Fiscal Studies and the Office for Budgetary Responsibility, and even Health and Social Care Secretary Jeremy Hunt and other Cabinet members.

This is a bold move by the Prime Minister considering the pressure mounting for increased funding from other departments while HM Treasury is trying to keep costs down in the wider context of a low value for the pound. The funding is expected to come from a combination of increased un-hypothecated tax, increased government borrowing and a “Brexit dividend,” going some way to meeting Vote Leave’s campaign pledge to increase NHS funding by £350 million a week with the money no longer being sent to the EU and NHS calls for a four percent increase against HM Treasury’s reluctance to increase funding above 2.5 percent.

This comes after polling by the NHS Confederation found that 77 percent of people support a four percent increase in health spending over the next 15 years, and 82 percent supported a 3.9 percent increase in social care funding. This would increase the NHS budget from its current £128bn to £234bn by 2033.

Weekly political news round up – 8th June

June 8, 2018 in News by Whitehouse

Overview

This has been a tense week for the UK’s Brexit team as they published a position paper on the customs backstop (detailed below). Brexit Secretary, David Davis, had previously said he would resign if an end date was not put on and transition agreement but Prime Minister, Theresa May, has refused to commit to one. Foreign Secretary, Boris Johnson, has accused the Prime Minister of lacking “guts” in a speech he claimed was under Chatham House rules, but which mysteriously managed to find its way into the public domain and criticised Chancellor, Philip Hammond, and the Treasury of being “the heart of Remain.” We have not seen any resignations so far, but it is certainly a very volatile and tense political climate at the moment.

Disabled toilets deemed inadequate for children

The Times has reported on a survey of 113 disabled people conducted by someone with cerebral palsy who uses a wheelchair. The survey found that parents and carers of people with profound disabilities suffer from insufficient toilet facilities with proper equipment to the extent that it often prevents disabled people going out. Some families carried padded mats and blankets for their disabled child to lie on when they needed the toilet. Respondents to the survey say that the lack of provisions are unhygienic, undignified, and unacceptable. It noted that some children with such disabilities needed incontinence pads or colostomy bags changed when on the move.

Charities across the UK are campaigning for what have been dubbed “changing places” which are lavatories with wheel chair access and enough space for two carers, a changing bench and a hoist in all city centres, stations and public buildings.

Nic Bungay, Director of Campaigns at Muscular Dystrophy UK, said: “There are a quarter of a million adults and children with severe disabilities such as muscular dystrophy who could benefit from a changing places toilet.” The Department of Housing, Communities and Local Government said: “There are now 1,109 [changing places] toilets across the UK, up from just 140 in 2007, and we have helped fund the development of a new website so people know where to find them.”

Whitehouse met with Muscular Dystrophy UK’s Changing Places Team and arranged for them to discuss their work with relevant PCF members, who would then report back to the Forum.

Major health charities join forces to call for more health funding

Three major health organisations – the Health Foundation, the Nuffield Trust, and the King’s Fund – have written a joint open letter to Prime Minister, Theresa May, calling for increased funding for the NHS. Jennifer Dixon, Chief Executive of the Health Foundation; Chris Ham, Chief Executive of the King’s Fund; and Nigel Edwards, Chief Executive of Nuffield Trust, signed the letter which welcomed May’s announcement on a new long-term funding plan and multi-year funding settlement for the NHS, as well as the “relative protection of the health budget since 2010.”

The letter argued, however, that “historically low funding increases and rising demand for services from a growing and aging population have left the NHS facing unprecedented pressures and struggling to maintain standards of care” as it supported calls for a four per cent a year increase in overall funding, as well as reform to ensure the NHS remains “sustainable.” It says that the NHS has met savings by reducing important activity in public health, capital investment and staff training which, it asserted, “is not a technical point, it has a material impact on patient care.” It calls for the ongoing reforms to be sufficiently funded. The letter focused on revitalising the NHS workforce which it says is in “crisis” and also needs a long-term strategy, and on the need to reform social care.

Health Secretary confirms NHS funding boost

Health and Social Care Secretary, Jeremy Hunt, has asserted that the NHS will get a “significant increase” in its budget as part of its 70th birthday celebrations, The Guardian has revealed. Hunt claimed that Prime Minister, Theresa May, was motivated to increase funding in order to show that the Conservatives can be trusted with the NHS, and to tackle chronic understaffing coupled with the increased demand stemming from an ageing population. He also said that May would fulfil her promise of implementing a “long-term plan” for the NHS. Hunt called May “unbelievably committed” and asserted that “now the economy is back on its feet” the Government is able to review NHS spending.

However, whilst HM Treasury is under pressure from multiple departments to increase funding it is keen to keep costs down. While DHSC and the wider health community is calling for a minimum of a four per cent a year increase, The Treasury believes it cannot afford more than 2-2.5%. In expressing his support for a long-term funding strategy, Hunt noted the short-sightedness of the recent policy of small, ad hoc increases and emergency injections of cash, calling them “unviable.”

Hunt admitted that the Government was unlikely to meet the target he first made in 2015 to increase GP numbers by 5,000 by 2020 and acknowledged the impact of Brexit on staff shortages. He said, “We do need 5,000 more GPs” but “it has been harder than we thought.”

This looks promising for NHS funding however nothing will be confirmed until the Chancellor’s Autumn Budget in November and it is likely both DHSC and HM Treasury will have to compromise and the NHS will get a funding increase somewhere in between the Treasury’s preference of 2-2.5 percent and DHSC’s call for four per cent. It will be important to raise awareness of the needs of children and young people with continence issues as such services will be competing for limited funds with other health provisions.

Scottish Government consults on supporting Disabled Children, Young People, and their Families

The Scottish Government is consulting on its proposals for supporting disabled children, young people and their families. The proposals span across the inclusive communication of people’s rights to who needs to know, accessibility to support, and transitions to adult care. This is in response to a survey conducted by the Scottish Government which found that families wanted to have centralised resources that are signposted, and resources to span over the legal rights and support mechanisms available. The Scottish Government’s aim is, therefore, to develop “a central, inclusive source of information” available online and on a mobile app.

The deadline for submissions is the 5th September. The consultation does not reference continence directly but this is a good opportunity to try to make the EICC more accessible to service users. Whitehouse will draft a response to the consultation from the PCF.

Weekly political news round-up – 1st June

June 1, 2018 in News by Whitehouse

Overview

NHS Trusts in England have reported a combined £960 million deficit over the past financial year, nearly twice the figure anticipated by NHS bosses. Prominent health think-tank the Nuffield Trust said the figures are much worse than they appear on paper, given the deficit takes into account the additional financial support provided by the Government in the Budget last November. Chris Hopson, Chief Executive of the Hospital Trust association, NHS Providers, said a 5% annual increase in funding is needed to match European levels of care, noting that, “everywhere you look you get a sense of the NHS under real pressure.” The rise in demand for hospital services is a major contributor to the burgeoning deficit, with another report finding this week that the number of emergency readmissions have risen by a fifth over the past seven years.

Meanwhile, Jeremy Hunt becomes the UK’s longest-serving Health Secretary of all time this weekend, beating Norman Fowler’s previous record of 5 years and 272 days in the role. Hunt’s milestone has been complemented by news that the he has been spared sanction by the Parliamentary Standards Commissioner for the late reporting of his pecuniary interest in the property company Mare Pond. The Health Secretary apologised for his non-disclosure after it came to light, with the Commissioner, Kathryn Stone, declaring this week that Hunt’s infraction was “at the less serious end of the spectrum”.

Studies warn of poor toilet training, genetic link to bedwetting

A study carried out by Swedish health and hygiene company and PCF company member, Essity has found that school children risk contracting bladder infections and potential bowel and continence problems as a result of poor toilet training, and poor school toilet hygiene. The report – based on interviews carried out by YouGov with more than 400 primary school teachers and 500 parents and children – found that 44% of children avoid using the toilet at school at some point every week, while 4.7 million children actively avoid defecating at school. One in 10 primary school teachers said they have seen children abstaining from eating or drinking in efforts to avoid using school toilets, while more than half of teachers are concerned about the impact accidents on other children in class.

The Director of the NAHT Edge teachers’ union, James Bowen, said “we are concerned about the increasing number of school leaders who are telling us that children are arriving in school unable to use the toilet independently.” He said that “this appears to be a growing problem”, adding, “with school budgets under enormous pressure, the reality is that most (schools) are finding it increasingly difficult to repair and upgrade such essential facilities.”

Another study released this week has suggested that bed wetting can be caused by a child’s genetic make-up. The research carried out by academics at Aarhus University Hospital in Denmark discovered a genetic combination which makes some young people 40% more likely to wet the bed, contradicting the notion that the issue is purely caused by psychological activity. A spokesperson for ERIC said that while bed wetting at night “isn’t caused directly by psychological issues”, stress can play a part.

Trusts lean on bank nurses to curb agency spending

NHS Improvement is reporting that spending on agency nurses fell by 20% in the last financial year, as trusts have increased their use of ‘bank’ nursing staff within hospitals. The Department of Health and Social Care arms-length body, which regulates all NHS trusts, said a £93 million reduction in spending on agency staff across all NHS roles was “partly caused by moving agency workers and shifts into bank and substantive roles, which represent greater value for money than the equivalent posts”.

NHSI proclaimed the reduction as “a huge achievement in view of the record levels of demand and the extreme pressure on the acute sector”, with new Chair, Ian Dalton, saying the results are testament to “NHS staff up and down the country (displaying) incredible resilience” in the face of “epic challenges”. The regulator has prioritised a reduction in the use of agency staff, including nurses, in NHS hospitals due to rising concerns over its impact on NHS finances over the past few years. Last year, then Chief Executive, Jim Mackey, wrote a letter to all trusts telling them to “redouble” their efforts and “go further” to cut agency employment costs.

While the reduction in agency spend has been cited as a success for the NHS, HSJ is reporting a related overspend on bank staff by almost £1 billion across the NHS provider sector. Royal College of Nursing Chief Executive, Janet Davies, said the figures reveal “a cash-starved NHS forced to run without enough staff to treat people safely.” She argued that, “as long as hospitals remain £1bn in the red, patients will pay a heavy price.”

Bank staff benefit from more flexible working arrangements than nurses in substantive or permanent posts, but do not earn the high rates of remuneration given to agency workers or agency firms. Bank workers also enjoy substantially less employment protection and contractual rights than NHS staff working full-time under Agenda for Change terms, so NHS Improvement’s reaction to the shift towards greater utilisation of bank workers is particularly telling.

NHS trusts have consistently found it difficult to recruit appropriate numbers of staff in order to avoid a heavy use of temporary workers, and the employment of bank staff is, for the most part, simply a means of doing the same thing for less money. With 10% of nursing posts currently unfilled and a decreasing supply of EU-trained staff to rely on, Ian Dalton’s comments point to a new Chief Executive who is either overly eager to present good news, or critics and may result in criticism from those who feel that he is out of touch with some of the concerns of the NHS workforce and NHS organisations facing ongoing staffing issues.

“NHS Assembly” set to help create 10-year plan

NHS England and NHS Improvement have outlined their intention to set up a new “NHS assembly” to broaden stakeholder input into the Government’s forthcoming long-term plan for healthcare services in England. According to a board paper presented at a joint meeting between the two arms-length bodies last week, the Assembly will act as “the forum where stakeholders discuss and oversee progress on the Five Year Forward View and help codesign the proposed upcoming NHS 10 year plan”.

Assembly members will include national clinical, patient and workforce organisations; representatives from the voluntary, community and social enterprise sector; arms-length bodies; integrated care system and STP leads, as well as representatives from trusts, CCGs and local authorities. The concept was introduced by Simon Stevens last year, when he said that NHSE and NHSI were considering creating “some form of NHS council or assembly that brings together, on a regular basis, frontline organisations and national bodies”. Similar proposals have been made in the past, including through the NHS Modernisation Board in 2001 which was set up to advise then Health Secretary, Alan Milburn, on the implementation of the “NHS Plan”.

The Government will be eager to show that the new long-term plan for the NHS has been sufficiently scrutinised by key health and social care stakeholders. Whilst the range of stakeholders outlined for assembly membership is incredibly wide-reaching, the finer detail revealing those involved will be critical. Key tests will include the extent to which GPs are included (as ICS and STP leads tend to come from trust management), and the type of “patient and staff organisations” involved.

DHSC also risks further accusations of creating a forum for purely tokenistic consultation if it follows the model set through the current process for creating Accountable Care Organisations, where a lack of public engagement in the early stages has contributed to the current challenge being heard in the High Court. It is not clear to what extent the NHS Assembly will consider the future of social care, though it is notable that local authority stakeholders will be invited to join the forum.