Weekly political news round up – 28th October 2016

November 4, 2016 in News by Whitehouse

Overview

This week in Parliament, the transcript of the oral evidence session on NHS finances held by the Health Select Committee has been published, during which the NHS chief executive Simon Stevens clashed with Secretary of State for Health Jeremy Hunt on the amount of funding that the NHS will receive over the next three years. Mr Stevens and the Committee believe the figure is nearer to £4.5 billion as opposed to the £10 billion the Health Secretary suggested. The Government has also responded to the Health Select Committee’s report on primary care, which commits to the creation of a General Practice Forward View for the nurse workforce.

Outside of Parliament, the King’s Fund has released its assessment of the NHS’s Five Year Forward View, which has found that national bodies are using transformation funds to cover deficits as opposed to introducing and supporting new care models; and Scotland’s public services watchdog Audit Scotland has warned NHS Scotland is being hampered by staffing pressures and unprecedented savings targets.

A new school nursing text messaging service, known as ChatHealth, has been launched by Evelina London Children’s Hospital in Southwark and Lambeth secondary schools after the service’s success in Cumbria and other regions; and research carried out by the Local Government Association has found one quarter of hospital admissions could be prevented if proper community treatment was administered. Finally, Professor Ian Cummings, Health Education England chief executive, has put forward his support of regulating the new nurse associate role.

Parliamentary and political developments

Health Committee hears evidence on NHS finances

Last week, the Health Select Committee heard evidence for the one-off inquiry into the Department of Health and NHS finances from Jeremy Hunt MP, Secretary of State for Health; Simon Stevens, Chief Executive of NHS England; Jim Mackey, Chief Executive of NHS Improvement; and David Williams, Director General of Finance and Group Operations for the Department of Health.

Dr Sarah Wollaston MP, Chair of the Committee, asked Mr Stevens whether he believes the NHS has been given all the funding it has asked for as the Health Secretary has claimed. Mr Stevens outlined that the original estimate of how much funding the NHS needs in five years’ time was £8 billion – £12 billion, depending on various factors such as efficiency levels and investment in services. He said that in the five-year period, the NHS has received the “lower end” of the £8 – £12 billion, but for the next three years the NHS will not receive the funding it has previously requested – with the actual amount of additional funding suggested to be around the £4.5 billion mark.

Because of this, from 2017-2020 the NHS has a “bigger hill to climb”. 2018-2019 is likely to be the most “pressured year” financially due to negative levels of per person funding. The Committee said that there was broad agreement that if additional funding was to be given to the NHS, social care should be prioritised. Mr Hunt declined to comment on the contents of the forthcoming Autumn Statement, but conceded that financial pressure is particularly acute in the social care system. He advocated speeding up the integration of health and social care to achieve more efficient services and decrease unnecessary hospital admissions.

Government Response to Health Select Committee report on Primary Care

The Government has published its response to the Health Select Committee’s fourth report on primary care for the 2015-2016 parliament session, which welcomes the Committee’s focus on general practice and the services it provides. The Government acknowledged that access to primary care is vital and that it is committed to improving access to GP services as part of the seven-day NHS plan. £175 million has been invested in the GP Access Fund and there are now 57 schemes covering 2,500 practices which have benefited from improved access and transformational change. The main measures which the report advocates are:

  • Increasing funding for primary medical care by £2.4 billion per year by the end of 2020-2021;
  • Increasing the number of GPs through offering new incentives;
  • A new practice resilience programme should be produced to support struggling practices;
  • Local STPs should address workload and workforce issues; and
  • New models of care should be tested by multi-specialist provider vanguards and GP Access Fund sites.

The report also recommends that Health Education England, NHS England and the Royal College of Nursing develop a plan for primary care nursing, akin to the ten-point plan for general practice. HEE is leading the development of a general practice nursing strategy, which is due to be announced in late autumn 2016. The General Practice Forward View sets a minimum of £15 million to be invested in a development strategy. It will include: improving training capacity in general practice; increasing the number of pre-registration nurse placements; measures to improve retention; and support for return to work schemes for practice nurses.

Clinical developments

ChatHealth launching in Southwark and Lambeth after Cumbrian success

The Evelina London Children’s Hospital has become the first London hospital to roll out ChatHealth, a text messaging service that allows secondary school children to message school nurses for health advice and support. ChatHealth was trialled in Leicestershire, and has also found success in Cumbria after the Cumbria Partnership NHS Foundation Trust launched the new scheme in September, which has treated more than 60 children. Some of the messages have resulted in face to face meetings between the children and nurses involved.

Each school in Southwark and Lambeth has been allocated a visiting nurse who will manage the service. These nurses are part of a wider school nursing team and are based in local community health centres where they answer pupils’ messages. Pupils can ask for advice on a range of issues and even make an appointment with a school nurse through a text message. Janet Powell, director of nursing at Evelina London, believes that utilising technology in health services will hopefully “engage young people who may otherwise be difficult to reach”.

Research reveals that a quarter of hospital admissions are unnecessary

The Local Government Association has published research that shows up to one in four people admitted to hospital could be attended to elsewhere if community services were improved. The report suggests that approximately 26% of hospital admissions “could have been avoided if opportunities to intervene had been available or not missed” and that looking after people at home or in the community could lead to 45% of decisions on patient care being made more efficiently. It could also save the health and care system more than £1 billion by 2020.

The LGA has said it will be prioritising more funding for adult health and social care in its submission to the Treasury ahead of the Autumn Statement, which will be delivered on 23rd November. Councillor Izzi Seccombe, Chair of the LGA’s Community and Wellbeing Board, said in response to the findings that savings “would be achieved by shifting resources to support living more independently”. Commenting on social care, Councillor Seccombe emphasised her belief that the social care provider market cannot carry on as it stands, with wider implications for pressure on the health service.

Health Education England advocates regulation of nursing associate role

Professor Ian Cumming, chief executive of Health Education England, has said that nursing associates should be regulated, but he did not state which national body should regulate the role. The Nursing and Midwifery Council (NMC) has previously said it could be the regulator and would subject the new role to the same regime as registered nurses currently experience, with regards to revalidation, fitness to practice and standards. A HEE consultation on nursing associates found that the NMC was the most popular candidate for being the responsible body, but a decision cannot be made until the scope of practice is defined and risks to patient safety have been assessed by national bodies.

However, the Health Secretary Jeremy Hunt also said in an interview with Health Service Journal this week that the UK’s departure from the EU lends the Government the opportunity to reform professional regulators such as the NMC. Mr Hunt criticised the NMC for the speed they deal with issues, but conceded that Parliament has also failed to find time to make legislative changes to improve the situation. There is therefore “a Brexit induced opportunity here because we will have to relook at all the regulations post-Brexit.”