Prime Minister, Theresa May, and Home Secretary, Amber Rudd, have been widely criticised for implementing policies which have seen many people who moved to the UK from the West Indies in 1948 as part of the ‘Windrush Generation’ deported after wrongly being identified as illegal immigrants. The policies were enacted during Mrs. May’s tenure as Home Secretary. when policy papers from her Department detailed “a really hostile environment” for illegal immigrants. During her tenure at the Home Office legislation was brought about which compelled public service providers, including NHS staff, to withhold services from people who could not prove their citizenship, despite the fact that the landing cards of Windrush immigrants had been destroyed. The policy has been criticised by some who felt it could have a negative impact upon community cohesion. Mrs Rudd had committed to increasing the number of deportees by 10 percent a year. The Government has since issued a formal apology, but the media storm continues.

King’s Fund reports on the rising cost of medicines

The King’s Fund has published a report entitled The rising cost of medicines to the NHS: what’s the story? in which it reviews how much the NHS spends on different kinds of medicines and the impact of the Pharmaceutical Price Regulation Scheme, as well as predicts likely medicine price controls policymakers are likely to implement in the future. It references NHS England’s OTC consultation and it highlights that “policymakers have recently sought to exert greater control over medicines expenditure” to handle the growing incompatibility between spending and budget.

The report finds that “NHS spending on medicines in England has grown from £13 billion in 2010-11 to £17.4 billion in 2016-17”, which averages a five per cent increase a year. This increase has disproportionately impacted the hospital sector, which has seen an average increase of 12 per cent. In primary care, the almost doubling of prescription items provided to patients in the decade to 2016 has been offset by a nearly 25 per cent reduction in the average cost of prescription. It concludes that “Without a new funding settlement for the NHS, policy-makers are likely to face increasingly difficult choices. There is a risk of returning to the position of the 1990s, when funding pressures led to widespread concern about patients’ access to medicines.”

This report by the influential King’s Fund raises questions about the effectiveness and sustainability of cost-saving measures such as prohibiting the prescribing of OTC medicines considering the scale of savings required.

RCPCH publishes report calling for more healthcare resources to keep children safe

The Royal College of Paediatrics and Child Health has published its Facing the Future: Standards for Acute General Paediatric Services. It says that more resources are needed for children’s health services to prevent doctors from “burning out” and services becoming “more unsafe”. It calls for an increase in paediatric consultant presence during peak hours, which are 8 a.m. and 10 p.m., to improve hospital care. It found that most wards could not guarantee a consultant would be present, even at busy times and called for between 84 and 110 extra consultants to be recruited in Scotland over the next five years, considering units were often unable to deliver consultant support and most units do not have a “linked consultant paediatritian” for GP practices.  The report calls for the Department of Health and Social Care to identify “the barriers to implementing guidelines and standards then create an action plan to overcome them”. It says that the Government must commit to developing a cross-departmental child health strategy for England by 2019”.

Dr Carol Ewing, RCPCH vice president for health policy, said: “It is down to the sheer dedication of our doctors that children are being treated as safely as they possibly can on paediatric wards in the UK but the risk of ‘burn-out’ is all too real.”

We will continue to monitor for the development of a cross-departmental child health strategy for England and seek ways in which to engage.

CCG risks NHSE intervention over deficit plan

HSJ has reported that Hambleton, Richmondshire and Whitby CCG held an extraordinary board meeting this week, as it realised that it will not meet its breakeven control total for 2018-2019. It faces a £4 million deficit, which might result in action by NHS England. The CCG had an allocation of £186m for 2017-18, which will rise to £188m this year, according to the latest NHSE figures. It had a forecast outturn deficit of £6.7 million for 2017-18, having ended the previous three years in surplus. The CCG’s breakeven control total means that it is not eligible for any commissioner sustainability funding.

A spokeswoman for the CCG said: “The governing body confirmed that the CCG will be submitting a deficit plan for 2018-19 of £4.05 million. The plan does not meet the requirement to breakeven and there will therefore need to be further discussion with NHS England on the next steps.”

This news further demonstrates the extent of the financial constraints some CCGs are findings themselves in. As they will continue to look for cost-saving measures, continence care remains under threat of cuts. It is important that the PCF continues its engagement in this area to highlight the long-term cost savings that treating continence issues early generates, and especially so when such services may have to compete for funding.