Paediatric Continence Forum
Political and Parliamentary Monitoring
Week commencing 23rd July 2018

This week, the Government announced a pay rise for doctors, although the increase is below the recommended two per cent made by the NHS pay review body. The Health & Social Care Secretary, Matt Hancock, said that he had taken note of the low morale amongst staff, but the offer was quickly dismissed by the British Medical Association, who attacked the Government, saying this would “make a bad situation much worse”.

From October 2018 Junior Doctors could see their pay increase by a minimum of £532 per annum, whilst consultants will see a boost of £1,150. However, the 1.5 per cent rise announced is less than the rate of inflation and comes after years of real terms pay cuts for health professionals. The offer is also lower than the two per cent recommended for salaried doctors by the independent pay review body. The Government said this pay award took into account the three-year contract reform of the Agenda for Change contract, the long-term funding settlement and contract reform for GPs. A third of the increase will come from a new system of performance-related pay.

The news that doctors are set for an increase in pay comes in the same week that the nursing sector has been hit with confusion about their own pay awards. The head of the Royal College of Nursing has apologised after nurses in England complained of being “misled” over a new pay deal. The union had said they would receive a 3 per cent increase in pay as part of a three-year pay deal. However, some nurses have complained of receiving significantly less – in some cases just a few pence extra each month.

It transpires that only those at the top of their pay band will get the 3% immediate rise, whilst others will get on average 1.5% until their incremental pay-rise date is reached, at which point staff will be eligible for a further increase. For many, however, any incremental increase could be many months away.

This latest debacle over pay and conditions will fuel concerns over NHS management. There are currently over 35,000 nursing vacancies in England, and anger amongst their profession is unlikely to draw new members in to their ranks.

• Cautious welcome for government response to ‘The Nursing Workforce’
• Hancock says public health funding not the responsibility of the Department for Health
• New technology key for success in the NHS

Government responds to report on ‘The Nursing Workforce’
The Government has responded to the Health and Social Care Select Committee report ‘The Nursing Workforce’, outlining measures that will be taken to address the acute shortage or nursing staff, and to increase morale amongst the profession. The report suggested that the NHS should assist those nurses who want to move between departments or train in specialist areas, whilst it also calls for reversal in the cuts to nurses’ professional development budgets.

Responding to the report, the Secretary of State, Matt Hancock, said that he wanted to ensure that nurses “feel valued at work”. He announced that NHS England and NHS Improvement are collaborating on a programme to develop, test and implement a “place based” model, to test new approaches which should make it easier for staff to move around the health service.

However, there was no dramatic shift in government policy on bursaries for student nurses. Hancock’s response said that “The Government has been clear that the bursary funding system was not working for patients, for students, or for the universities that train them.” Hancock defended the Government’s current position, indicating that eligible healthcare students have access to additional provision for travel to clinical placements and an “exceptional” support fund. He also lauded the repayment plan on graduate loans.

The Government’s response to the Select Committee’s report was welcomed cautiously by many in the health service and will be of interest to the PCF. The prospect of making it easier for nursing staff to enter the paediatric nursing sector will be welcomed by many, although the news that the funding support for student nurses is unlikely to change will cause alarm given the number of nursing vacancies hit a record high at the beginning of the year.

Whitehouse will continue to monitor the Government’s plans for the nursing workforce and any consultations that arise from it.

Hancock fails to support public health funding
The Health & Social Care Secretary, Matt Hancock, has come under pressure for signaling that it is not the role of the Department for Health to fund public health spending. Appearing before the Commons’ Health and Social Care Select Committee on Wednesday, Mr Hancock was questioned about the planned 4 per cent reduction in public health grants to councils up to 2020-2021.

In response, Mr Hancock said that, whilst he agreed with taking preventative measures as it decreases higher costs later, he insisted primary care was as important as prevention in improving public health. He then went further and insisted he did not think it was “ever intended that the Department of Health & Social Care should be the biggest funder” of public health.

. Since public health responsibilities were transferred to local authority control, funding has been slashed year-on-year. Indeed, as central government grants to local authorities have been reduced by up to 40 per cent, public health funding has often been the first victim of service reductions and some may question as to whether the Department of Health & Social Care should have more concern over public health given that, whilst it is now under the jurisdiction of local government, the effects of poor public health provision and prevention services can impact upon the NHS, as ailments exacerbate due to lack of effective treatments

The news that there is little appetite from the Department of Health and Social Care to help plug the public health funding gap will concern many PCF members. Since school nurses, many of which oversee paediatric continence care, were transferred to local authority control, their numbers have dropped. Any further reduction in the grant could mean a further reduced service, and an increase in the postcode lottery which already affects thousands of children and young people.

Whitehouse will continue to monitor local authority public health funding, and track where any changes coincide and link with the data collected under the FOI audit of councils which was undertaken last year.

Technology key to solving NHS crisis
The new Health & Social Care Secretary has said that technology and the use of apps is the key to solving the NHS crisis. In an interview with the BBC, the former Secretary of State for Digital, Culture, Media & Sport, said there was “loads to do on that [technological] area”, and declared his job was to make government more tech savvy and digital.

The Secretary of State added that technology could make the NHS more convenient for patients, but could also improve the working lives of doctors and nurses. Hancock is familiar with developing apps, having developed his own ‘Matt Hancock App’ to provide residents in his West Suffolk constituency with an update on his parliamentary engagements.

The news that the Secretary of State is interested in developing technology further comes in the same month that it was announced a new NHS app would be launched by December which would end the 8 a.m. scramble for GP appointments by allowing patients to communicate directly with clinical staff over their phone. In a fresh development, Thomas Cook said that it would use similar technology to offer tourists who have taken travel insurance out with the company an opportunity to have video consultation, and have treatment prescribed electronically.

Whilst the prospect of new technology may be received with a cautious welcome by many PCF members, especially as it has the prospect of reducing the time it takes for children and young people to access treatment, it cannot replace the benefits of face-to-face diagnosis, and ensuring that those children who need medical treatment can be referred in a timely fashion.

The PCF will continue to monitor which NHS Trusts are utilising new technology, how it is being implemented, and how successful it is.