Weekly political news round up – 21st October 2016

October 24, 2016 in News by Whitehouse

Overview

The Department of Health has announced a new nursing-specific post that will focus on nursing and allied health professional policy issues, including parliamentary business. Deborah Glover, member of the Royal College of Nursing, triggered a Government response when she created a petition to oppose the Government’s decision to scrap the nursing directorate in the Department of Health, which attracted more than 10,000 signatories. Commenting on the Government’s decision, Ms Glover said: “It’s positive that a new nursing post will form part of the new structure”. She also said she looks forward to working with the Department of Health to ensure nursing is incorporated into health policy that will impact on patient care

This week in Parliament the Prime Minister reportedly told the chief executive of NHS England, Simon Stevens, that the NHS will not receive additional funding in the Autumn Statement. The reforms to community pharmacy have been finalised by Parliamentary Under-Secretary of State for Community Health and Care, David Mowat; and Mrs May scrapped the Cabinet’s health and social care taskforce. NHS Wales was also promised a 2.5% increase in funding from the Welsh Assembly’s 2017/18 budget.

Outside of Parliament, Cumbrian school nurses and health visitor services face being terminated to enable Cumbria County Council to cut children’s public health spending by more than £700,000. The Royal College of Nursing has warned the Government of the potential for a “perfect storm” in the worsening of the current nursing recruitment and retention crisis; and the Secretary of State for Health Jeremy Hunt revealed that he plans to prioritise children’s mental health services and reduce NHS dependency on agency staff over the coming years.

Parliamentary and political developments

Government publishes reforms to community pharmacy funding

David Mowat, Parliamentary Under-Secretary of State for Community Health and Care, announced  details of the changes to community pharmacy funding to the House of Commons this week. Mr Mowat stated

that while the Government appreciates the role of the community pharmacy sector in relieving pressure on other primary care facilities such as urgent care, the current system does not promote consistency or quality. Currently 40% of pharmacies are in geographical clusters of three or more, and two out of five pharmacies are within a ten-minute walk from each other.

For 2016/17, community pharmacies will receive £2.687 billion in funding – representing a 4% reduction – and in 2017/18 they will receive £2.592 billion, a further 3.4% reduction. From 1st December 2016, payment structures will be simplified and a payment for quality of services will be introduced, meaning pharmacies will not only receive payments for the volume of prescriptions they dispense but also the level of care provided.

NHS England has said that it will be supporting the transformation of community pharmacies through a £42 million Pharmacy Integration Fund. The money will go towards new clinical pharmacy services, working practices and digital platforms that are intended to meet public expectations and demand. In the statement made by Mr Mowat, he could not confirm how many, or if any, pharmacies will close due to the funding reductions. His department has said the reforms will “modernise the community pharmacy sector” and will not adversely affect patient access to community pharmacies. Labour’s newly-appointed Shadow Secretary of State for Health, Jonathan Ashworth, accused the Government of failing to “engage constructively” with the Pharmaceutical Society Negotiating Committee over the cuts, and labelled the plans a “false-economy”. Industry representatives also believe the cuts will have a detrimental impact on community pharmacy services and access. Rob Darracott, Chief Executive of the trade association Pharmacy Voice, said that the reforms are “incoherent, self-defeating and wholly unacceptable”.

Draft Wales Budget 2017-2018 promises 2.5% increase in NHS funding

The Welsh Government has proposed £276 million for NHS core services in the draft Welsh Budget for 2017-2018, representing a 2.5% increase in real terms in health funding. From 2017-2018, £240 million will be given to the Welsh NHS to meet the growth in demand and costs of services, and £60 million will be invested in the Intermediate Care Fund, which aims to help people be independent in the community and prevent unnecessary hospital admissions. Over the next four years, the money committed to infrastructure will also involve an investment of £1 billion to transform and maintain the NHS estate.

Anita Charlesworth, Director of Research and Economics at the Health Foundation, has welcomed the Welsh Government’s recognition of the pressures the health service faces. However, she also highlighted that the money must “support the transformative change and improved efficiency” needed to meet the long-term challenges the Welsh NHS faces. Welsh Assembly Committees will now hold evidence sessions on specific issues within the draft budget, which will contribute to the Finance Committee’s report on the Welsh Budget 2017-18 to be presented to the Assembly. The Assembly will use the findings of the report when considering the motion to approve the budget.

Health Select Committee hears evidence from Health Secretary and NHS England’s chief executive

The Prime Minister has reportedly told the chief executive of NHS England, Simon Stevens, that the NHS will not be eligible for any additional funding in the Autumn Statement on 23rd November, despite continued calls from the health sector. During her first meeting with Mr Stevens since becoming Prime Minister, Mrs May is reported to have urged him to instead consolidate the £22 billion efficiency drive already planned for the NHS over the coming years, using her own experience of “painful cuts” to the Home Office’s budget while she was Home Secretary to substantiate her decision.

Mr Stevens then publicly questioned the Government’s claim that the NHS will receive an additional £10 billion by 2020 in a session with the Health Select Committee. He told the Committee that for 2017/18, 2018/19 and 2019/20 the NHS did not receive the degree of funding requested, and so “as a result we have a bigger hill to climb.” The Health Secretary also gave evidence to the Committee during the session, and suggested that any additional funding announced in the Autumn Statement would be directed to social care rather than the NHS, given the growing pressures in the sector and their knock-on impact for the health service.

Prime Minister scraps Cabinet’s health and social care taskforce

The Government has published an updated list of cabinet committees and implementation taskforces, which shows that the Prime Minister has chosen not to continue with a cabinet committee for health and social care, as established by David Cameron. The former Health Minister, Dr Dan Poulter MP, said it was “regrettable” that the Committee had been scrapped, and that “it would be deeply concerning if this in any way indicated an intention to deprioritise government efforts to improve care for the frail, elderly and other vulnerable people who are in need of social care.”

One of the committees set up instead, chaired by the Education Secretary Justine Greening, will focus on childcare; with the remit to “drive delivery of a coherent and effective government-wide childcare offer to support parents to work.” The Prime Minister’s decision to chair four of the five cabinet committees herself – compared with two which were chaired by David Cameron – has been interpreted as an assertion of her strength. Jill Rutter, of the Institute for Government, said that “It is clear that [May] intends to assert herself” from this reduced degree of delegation.

Health Secretary gives interview on priorities to Health Service Journal

Jeremy Hunt has said in an interview with Health Service Journal that the number of nurses employed by the NHS should rise as NHS providers reduce dependency on expensive agency and locum staff. According to the Health Secretary, there has been an increase of around 10,000 whole-time equivalent nurses in the English NHS since 2012. He intends to prioritise children’s mental health in the NHS, stating it is the “biggest single area of weakness in NHS provision”. The integration of children and adolescents’ mental health services (CAMHS) into schools was proposed to allow the NHS to “make a lot of headway” in treating children’s mental health conditions.

In the interview, Mr Hunt also stated that he wants to remain as Health Secretary for another two or three years, which would make him the longest-serving Health Secretary ever. He also acknowledged in a speech to the GP Best Practice conference this week that underinvestment in GP training throughout his tenure as Health Secretary has now “caught up” with him, stating he could have taken a longer-term view to planning and funding the health service.

Clinical developments

Cumbrian school nurses and health visitor services face being cut

School nursing services in Cumbria face being terminated, in a bid by the local authority to cut children’s public health spending by more than £700,000. Cumbria County Council’s decision has been called a “disaster” by a former public health director, and has said it implies that children in the county are not considered a priority.

Currently, there are eleven full-time equivalent school nurses working in Cumbria. A report by Colin Cox, Cumbria Council’s assistant director for health, care and community services, revealed that the service is unsustainable because it is under-resourced. Instead, the report advocates six “health coordinators” to replace the school nurse service and for the number of health visitors to be reduced from 87.5 full-time equivalents to 71. Both of the services are provided by Cumbria Partnership NHS Foundation Trust, who has said that redundancies cannot be ruled out should the proposals go ahead.

Professor John Ashton, former director of public health in Cumbria, has called for the plans to be rejected. He said “School nurses are in the front line. How can they give a better service by getting rid of them?” Professor Ashton also listed obesity, fitness and mental health as the health challenges children are currently facing that could be compromised by reductions to school nursing services.

Royal College of Nursing warns of ‘perfect storm’ for worsening nursing shortage

The Royal College of Nursing (RCN) has warned that the current nurse shortage in the UK is likely to get worse if the Government does not take immediate action to tackle recruitment and retention problems. Describing the conditions the workforce is up against as a “perfect storm”, the RCN said that rising demand; an ageing workforce nearing retirement; insufficient numbers of trainees; and potential threats to international recruitment stemming from Brexit, are all contributing to the staffing crisis.

Official data from NHS Digital shows that overall the NHS workforce increased by 1.7% in 2015, but the number of learning disability nurses reduced by 23% and the community nursing workforce dropped by 11%. Additionally, the decision to remove bursaries for nursing students puts the number of trainee nurses at risk and could lead to an uneven distribution of trainees across regions and specialities. Janet Davies, RCN chief executive and general secretary, said that “the government has largely ignored the crisis facing the nursing workforce” and called for a “coordinated, long-term strategy to train more nurses”.

The Secretary of State for Health Jeremy Hunt announced at the 2016 Conservative Party Conference that his department is going to increase the number of medical student places, but laid out no plans on how to increase the nursing workforce. The RCN’s report confirms that the nursing profession faces significant obstacles over the coming years, particularly for speciality services such as mental health, community and disability nursing.