Paediatric Continence Forum
Political and Parliamentary Monitoring
Week Commencing 27th August 2018

The number of GP partners in England fell sharply by 308 from March to June 2018, new figures have revealed. GP partner numbers have fallen by 10% since September 2015, whilst the total GP workforce as a whole has shrunk by 4%. In September 2015, former Health Secretary Jeremy Hunt said it was his aim to have an additional 5,000 GPs employed nationwide within the lifetime of the Parliament, yet since then there has been a drop of over 1,400 GPs. 500 GPs left the profession in the March-June period alone.

Chair of the General Practitioners Council, part of the BMA, Dr. Richard Vautrey, warned that “GP recruitment [is in] crisis” adding that “the situation is in fact getting worse”. The continued decline in the number of GPs across the country is placing extreme pressure on practices and on GPs who are already working above and beyond to meet growing patient demand. A combination of rising workload and falling pay has led to a marked decline in the number of GPs choosing partnership roles.

The decline in the number of GPs will be of concern for the PCF. With the decline in the number of school nurses, many families will turn to their local GP for advice. The news that their numbers are also depleting will therefore be of great concern, especially as patients may be forced to turn to A&E and other emergency services.

Whitehouse will continue to monitor health employment statistics.

• RCN admits error on pay deal
• NHS bosses turn to private firms
• Number of new nurses not enough

Royal College of Nursing admits communications error
The Royal College of Nursing has pledged to make “lasting change” in the wake of the recent pay debacle which saw its Chief Executive, Janet Davies, announce she was stepping down. Ms Davies had previously made a public apology. Whitehouse reported over a month ago that errors in communication and negotiation had meant that many nurses were offered minimal pay increases despite being guaranteed much more. An external review is underway into the governance processes which hampered “understanding and communication”.

RCN activities launched a petition in July calling on Royal College leaders to stand down. Over 1000 members signed the petition, which has also triggered an emergency General Meeting which is to take place in Birmingham next month. The anger and frustration stems from a guarantee the RCN gave member of a three per cent pay rise backdated. This turned out not to be the case, with only half of staff getting the rise straight away.

Dame Donna Kinnair, the RCN’s Acting Chief Executive and General Secretary, said that “whatever the conclusions of the review, we already know that the RCN’s processes around the pay deal and its communication were not up to the standards” expected. The RCN has already released early details of meeting over its handling of the pay deal for nurses, which suggested that the RCN had not been clear in the way it had explained the proposed pay deal.

Whitehouse will report on any news of a replacement for Ms. Davies, as well as the result of the investigation.

NHS bosses urge hospitals to send patients to private firms
NHS bosses have urged hospitals to send patients to be treated by private healthcare firms in a bid to reduce the increasing number of patients waiting for planned operations. Whilst the move has sparked claims that it will waste scarce NHS funding by directing money in to the private sector, it is hoped the end result will be shorter and more manageable waiting times. The total number of patients in England on the waiting list in June was the highest figure for ten years.

In response to news that many hospitals are finding it impossible to treat 92% of patients within the supposed 18-week maximum waiting time, which is one of the NHS’s key performance targets, NHS England’s National Director, Matthew Swindell, said that: “Where trusts determine that they will no longer be able to meet their activity and performance commitments in their board approved plan you should work with your trusts to determine how these gaps will be closed through use of capacity in other trusts and/or the independent sector.” The letter also instructed local commissioners to reduce the number of those waiting over 52 weeks by at least 50 per cent.

In response, NHS Providers Chief Executive Chris Hopson, agreed that the “current elective performance is concerning”, but warned that a significant private sector drive could “destabilise” cash-strapped trusts and would simply mean “taxpayers paying a premium” for private clinics to take on NHS work. Mr Hopson added that many hospitals had been prioritising A&E and cancer care in light the NHS England Five Year Forward View, which gave what he considered “a clear signal” about where resources should be directed.

Whitehouse will monitor waiting times, and where necessary combine this data with the results of the PCF’s FOI audit.

Number of new nurses “will not tackle currency vacancy levels”
The number of nurses and midwives employed in Scotland is set to rise by less than 20 full-time posts this coming year, which is nowhere near enough to address widespread shortages, unions have warned. Scottish Government figures released this week show that the number of nursing staff is projected to rise by 0.01% in 2018-19, the equivalent to just an additional 20 roles. Nursing and midwifery numbers are expected to drop in many areas, with only a few locations seeing any notable positive impact. Overall, the number of nurses will remain at just under 60,000 whole-time equivalents.

NHS Ayrshire and Arran reported that a 4.2 per cent decrease in nursing and midwifery staff, which the Health Board claimed was a result of the closure of unfunded emergency care beds. NHS Glasgow and Clyde has also seen a drop in the number of nurses, meaning that Scotland’s largest city is going to be serviced by fewer healthcare professionals.

Whilst the PCF will find the reduction in nurses concerning, NHS 24 is investing heavily in country, with additional nurses set to be available via the telehealth and telecare organisations. This news is undoubtedly welcomed, but it is questionable whether NHS 24 will be able to take over the full capabilities nurses provide, such as face-to-face support and advice.

In response to the news, the Royal College of Nursing said that “Scotland needs more nurses” adding that “The projections set out today will not tackle the current levels of vacancies in the NHS boards, let alone take into account the continued increased in demand for health and care services across Scotland”.

Whitehouse will continue to monitor staffing levels.