Weekly political news round – 15th July 2016

July 18, 2016 in News by Whitehouse

Overview headlines

A study has been published suggesting that a symptoms-based clinical rule more-effectively predicts whether children will have Urinary Tract Infections (UTIs) than GPs’ clinical judgement. The research – the Diagnosis of Urinary Tract Infections in Young Children (DUTY) – examined 7,000 children with UTIs in primary care settings, and found that a symptom score was a more accurate predictor of infections than clinical diagnosis by GPs. Fever was also found to not be predictive of a UTI.

The King’s Fund has also warned that staffing levels will need to be reduced if the NHS’s finances are to be better controlled, after the deficit for the last financial year was confirmed as £2.4 billion. Helen McKenna, senior policy advisor at the King’s Fund, stated that “It is no longer credible to argue that the NHS can continue to meet increasing demand for services, deliver current standards of care and stay within its budget. This is widely understood within the NHS and now needs to be debated with the public.”

New Prime Minister retains Jeremy Hunt as Health Secretary

It was confirmed this week that Jeremy Hunt will remain as Secretary of State for Health in Theresa May’s new Cabinet. Conjecture was raised that Hunt was set to lose the post or move to another position within the Government, but the assurance in an official press release that he will continue in his previous role will provide a degree of continuity in the Department’s leadership.

However, the appointment of Phillip Hammond as Chancellor of the Exchequer could change the financial settlement for the NHS agreed by his predecessor, George Osborne. Although the commitment of £8bn of additional funds by the end of the parliament is likely to stay, the frontloading of this money may be delayed to accommodate adjustments in economic forecasts. Hammond seems set to avoid the stringent fiscal targets that characterised George Osborne’s time as Chancellor, could look to borrow to invest in public services, and has confirmed he will not impose an emergency budget as a result of the decision to leave the EU.

Elsewhere, Nicky Morgan has been replaced as Secretary of State for Education by Justine Greening. Greening was deemed a Conservative moderniser when first elected in 2005, and has garnered substantial experience since then: as a Shadow Minister at the Treasury and Communities and Local Government; then serving in Treasury, Transport and International Development briefs once in government. Her tenure at the Department for Education will be defined by how successfully she incorporates control of higher education and skills into its remit.

It is noteworthy that Ms Greening has no experience in the education sector, having never worked on the front line nor served in the Conservative education team. However, she will be the first Education Secretary to have been educated at a comprehensive school. At the time of writing it has not yet been confirmed whether the junior ministers in the Department for Education have retained their posts.

NICE updates guidance on diagnosis and management of UTIs in under 16s

NICE has updated its guidance on the diagnosis and management of UTIs in under 16s, renaming it from ‘urinary tract infection in children: diagnosis, treatment and long-term management’. The guidance does not cover children who are diagnosed with other kidney, bladder or urinary problems; children with improperly-functioning immune systems; children in intensive care units; or the long-term management of repeated UTIs in sexually active girls. The guidance was published in 2007, and the supporting evidence was updated in 2013.

The guidance separates the symptoms and signs of UTIs into infants younger than 3 months and infants and children older than 3 months; while urine testing strategies are categorised according to infants younger than 3 months, older than 3 months but younger than 3 years, and for children 3 years or older. It recommends that infants younger than 3 months with a possible UTI should immediately be referred to a paediatric specialist, and this should be considered for infants and children older than 3 months with acute infections. The full guidance can be found here.

Government to consider ending family health checks

Public Health England has been commissioned by the Department of Health to review the mandatory provision of five health checks to families, which will cease to be provided in March 2017 if the decision is not reviewed. The examination of the system had been due to begin in the autumn but has been brought forward; and will explore the options of renewing mandation, amending the number of visits required or removing the obligation to provide visits. The review is also looking at: what impact the transfer of commissioning for children’s 0-5 public health services to local authorities has had; the desire for the health checks to be mandated; the evidence of service transformation; and risks to the sustainability of the health services.

Fears have been expressed that a lack of a mandatory requirement to conduct the health visits will result in struggling local authorities reducing the number of visits or scrapping them altogether. Dave Munday, professional officer at Unite’s Community Practitioners and Health Visitors Association, has suggested that these cuts could increase pressure on other children and family services within the community; and argued that the Government should actually be looking to increase the number of visits conducted. The review is expected to report in the autumn, and submissions can be made here.

Physician associates “unlikely to fill essential workforce gaps”

The Health Foundation has released a report on NHS staffing, suggesting that roles such as physician associates are unlikely to ease workforce pressures in the NHS and that funding should instead be supporting existing roles. The report branded positions such as physician associates “headline grabbing” new roles, and intimated that despite a previous pledge to increase the number of training places for physician associates by more than 200% in 2016/17, “only 11 full-time equivalent PAs” were employed in general practice last year.

The report’s authors also warned that the vote to leave the EU could worsen NHS staffing problems. The findings were accompanied by statistics indicating that the percentage of patients who find it easy to reach their GP by phone has fallen for the fourth year in a row, to 70.1% (from 78% in 2012) – further suggesting workforce pressures. The proportion of patients who reported being able to get a GP appointment has also fallen by 2.9% since 2012, and happiness with practice opening hours has fallen by 5%.