This week, the Government has answered parliamentary questions on the Excellence in Continence Care guidance, and the Chancellor has delivered his Spring Statement. Public Health England has published commissioning guidance for health visitors and school nurses, while the Government has announced a review into outcomes for children with additional needs. The Royal College of Paediatrics and Child Health has also been taken over by a new President, Professor Russell Viner.

Written questions answered on EICC guidance

The Chair of the APPG on Continence Care, Rosie Cooper MP, has had three written questions answered on the adoption of the Excellence in Continence Care (EICC) guidance. The questions were:

  • To ask the Secretary of State for Health and Social Care, when he plans to publish the revised Excellence in Continence Care Guidelines;
  • To ask the Secretary of State for Health and Social Care, what steps (a) his Department and (b) NHS England is taking to ensure that commissioners in Clinical Commissioning Groups adopt the Excellence in Continence Care Guidelines; and
  • To ask the Secretary of State for Health and Social Care, if he will make it his policy to require Clinical Commissioning Groups to submit data to NHS England on continence care services.

Responding on behalf of the Government, the Public Health and Primary Care Minister Steve Brine said that NHS England is doing several things to ensure that CCGs are following the Guidance, including:

  • Ensuring CCGs can work with clinicians and commissioners from areas that have adopted the guidelines to improve their own services;
  • Exploring implementing a mandatory data set to provide information on the continence services commissioned by CCGs;
  • Encouraging CCGs to develop integrated commissioning arrangements with local authorities to improve the use of resources; and
  • Raising awareness of the guidelines through communication campaigns.

The response also clarified that there is no confirmed date for the publication of the revised guidance and said that “NHS England are exploring the mandatory data set and have a long term programme to increase the transparency of information available about the National Health Service.”

Chancellor delivers Spring Statement

The Chancellor presented the Spring Statement to Parliament this week, in which he confirmed expectations that the UK economy is set to grow more strongly than predicted in 2018 with improved public finances. According to the Chancellor, the Office for Budget Responsibility (OBR) has forecast more jobs, rising real wages, a falling deficit and shrinking debt in the coming years through to 2022. Despite this the Chancellor acknowledged that he was hesitant to increase public spending. Instead he suggested that possible public spending increases could be delivered in the Autumn 2018 Budget, provided public finances continue to reflect the outlined projections presented.

The Shadow Chancellor, John McDonnell, accused the Government of “astounding complacency” and failing to address the “crisis on a scale we have never seen before” in the UK’s public services. He added that the Government should end the politics of austerity and that “austerity was a political choice not an economic necessity”.

While the speech did not contain significant policy announcements, the Chancellor did announce that London would receive an additional £1.7 billion to deliver 26,000 affordable homes – including homes for social rent, aiming to take the total number to more than 116,000 by the end of 2021/22. He also set out a number of future consultations on proposed policies including a new VAT collection mechanism, and a plan to end the practice of late payments for firms – something which is particularly damaging for small businesses. Hammond did not release more funding for the NHS, instead claiming there will be more pay for NHS staff if management and workers reach a deal on a pay agreement by the time of the next budget in the autumn. This will continue to be a contentious issue for the Government with increasing pressure to alleviate the NHS’s significant budget restraints.

PHE publish commissioning guidance for health visitors and school nurses

Public Health England have published their commissioning guidance for health visitors and school nurses in support of the healthy child programme 0 to 19. The guidance is made up of four documents, with the first and second document making several references to continence issues and toilet-training as part of school readiness. Some of the key points from the documents are:

  • A statement that “Ready for school is assessed as every child will have reached a level of emotional development, which enables them to […] become independent in eating, getting dressed and going to the toilet”;
  • A recognition that one of PHE’s high impact areas underpinning its early years framework is “managing minor illnesses and reducing hospital admissions” and lists some of the aims underpinning the school nursing programme as “promoting healthy lifestyles; maximising achievement and learning; and supporting additional health needs”.
  • A statement that to support the objective of “more children and young people develop and achieve their potential through improved rates of school attendance”, schools should ensure there is “identification of continence issues and referral to appropriate services”.
  • A diagram which lists level 1 and 2 continence services as examples of services to support effective commissioning for children with additional or complex needs, and attributes the commissioning responsibility to LAs and CCGs respectively.

Government to review outcomes for children with additional needs

The Government has announced that the former Children’s Minister, Edward Timpson, will carry out a review into school exclusions and provision for children with additional needs to understand what can be done to improve the experiences for these children. The review will cover children with special educational needs, autism and children in care, and will be accompanied by a £4 million fund to progress steps to help children with additional needs move from alternative provision back into mainstream education or into special schools.

The Government stated when announcing the review that analysis has shown that these Children in Need are “three times more likely to have special educational needs than other children, and this compounds poor educational outcomes.” Edward Timpson said, “This review provides a real opportunity to fully understand what drives the different rates of exclusion in our schools system and the impact it has on the outcomes of children involved.” The Director for the Council for Disabled Children, Dame Christine Lenehan, said “We welcome these important announcements on behalf of children with special educational needs and their families.”

New RCPCH President assumes role

Professor Russell Viner has replaced Professor Neena Modi as the President of the Royal College of Paediatrics and Child Health. Professor Viner is an academic paediatrician and adolescent physician at the UCL Institute of Child Health and works in paediatric and adolescent diabetes. Writing in the British Medical Journal, Professor Viner called for the NHS to prioritise children and young people’s health, highlighting that “poor health in childhood leads to reduced workforce participation and productivity and lowers national wealth.”