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

Reshuffle confirms new ministers for Health and Education

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

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

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

DUP talks delay Queen’s speech

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

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

NMC releases consultations on nurse proficiency and medicines management

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

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

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

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

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

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

Hunt hints at end to pay restraint for nurses

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

NHS England Chief names first Accountable Care Systems

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

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

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