NHS England’s Chief Executive, Simon Stevens, has said that the NHS has “an enormous responsibility” to be financially responsible following the Government’s announcement of a 3.4 per cent annual funding increase for the Health Service over the next five years, breaking with the Government’s eight-year programme of austerity. It is important that the PCF raises awareness of the long-term cost savings of implementing paediatric continence provisions throughout England where the funding applies.

Shadow Health Secretary, Jonathan Ashworth, has said that the funding announcement, which falls short of the health sector’s claim that it requires four per cent just to maintain current performance, is not enough to tackle the NHS crisis in the midst of increasing demand coming from an aging population.

MPs debate toilet provision and accessibility

Labour MP for Dewsbury and Shadow Minister for Mental Health, Paula Sherriff, has moved a Bill in the Commons Chamber on Toilets (Provisions and Accessibility), calling for certain buildings to have “Changing Places,” toilets which are accessible to “people with complex needs” such as a height-adjustable, adult-sized changing bench, a tracking hoist system or mobile hoist, and adequate space for a disabled person to have two carers, a centrally placed toilet with room either side, a screen or curtain for privacy, a wide tear-off paper roll to cover the bench, a large waste bin for disposable pads, and a non-slip floor. Changing Places are currently recommended for some buildings; this Bill would make them mandatory for “large new builds, complexes with public access, or sites where visitors can reasonably be expected to spend long periods of time.”

The UK’s 1,123 Changing Places are disproportionately concentrated in large cities and there are some areas which do not have such facilities within 100 miles. Sherriff asserted that over a quarter of a million people cannot use standard accessible toilets in the UK, including 30,000 people with cerebral palsy, as well as 40,000 people with profound and multiple disabilities, and 10s of thousands of people with other complex needs. She noted that “the number of people with complex disabilities is growing” as technology advances and saves people’s lives and people live longer and said the extent to which lack of facilities prohibits people from going out is “a sad reflection on our society’s priorities.” It can result in disabled people “facing the indignity of being changed on the dirty floors of public toilets,” people staying at home and social isolation.

This Bill will be read for a Second time on Friday 23rd November.

We will reach out to Sherriff inviting her to meet with the PCF so we can introduce the Forum and its campaigns and invite her to support us going forward.

Driver Youth Trust launches SEND Governance Review Guide

The Department for Education has collaborated with literacy charity Driver Youth Trust and Whole School SEND, a consortium of SEND campaigners, to launch a SEND Governance Review Guide which sets out a framework for how to ensure that learners with SEND access high-quality provision. When publishing the Guide, Driver Youth Trusts Chief Executive, Chris Rossiter, highlighted in TES that SEND children have the poorest academic outcomes of any demographic, with only 18 per cent of Key Stage 2 children with SEND meeting the expected standards in the three Rs in 2017, compared with 70 per cent of non-SEND children. The Guide provides advice for mainstream and special schools on how to ensure they meet their obligations in a financially strained environment.

The Guide sets out the features of governance which provides a basis on which boards can effectively and confidently discharge their duties with regards to offering high quality SEND provisions: strategic leadership, accountability, compliance, structure and processes, people management, and evaluation. The Guide lists potential next steps following a review; boards could create an action plan in line with existing strategic plans to keep up to date; a review of policies to ensure they are compliant and sufficiently signposted; active engagement in peer reviews, and engaging the expertise of a National Leader of Governance.

NHS performance below that of international peers

The NHS at 70: How Good is the NHS? is one report in a series conducted by researchers from the Health Foundation, the Institute for Fiscal Studies, the King’s Fund, and the Nuffield Trust and commissioned by the BBC for the NHS’s 70th birthday. It compares the NHS with its international peers in five key areas: the relative strengths and weaknesses of the health service, the state of social care, NHS funding, the public’s expectations of the NHS and the potential of technology to change things in future. The report is an analysis of OECD data across 18 similar developed countries: Australia, Austria, Belgium, Canada, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Japan, Netherlands, New Zealand, Portugal, Spain, Sweden, and the USA. It pays particular attention was paid to the speed and accessibility of care, the efficiency of the system, and the outcomes delivered for patients.

The report found that the most notable strengths of the NHS included “unusually good financial protection to the public from the consequences of ill health.” The NHS had the lowest proportion of those countries examined of people skipping medicine due to cost; in 2016 2.3 per cent of patients did so compared with the average of 7.2 per cent. Despite media coverage, the NHS is relatively efficient, with the largest share of generic prescribing, at 84 per cent compared with the international average of 50 per cent. It spends less on administrative and managerial costs than most of the comparators, and it is particularly doing well at managing patients with long-term conditions out of hospital. A&E waiting times and waiting times for hip operations are average, again despite media criticism and deteriorating rates in recent years.

The NHS’s weaknesses, as identified by the report, include poor treatment of eight of the 12 most common causes of death, such as in the 30 days after a heart attack and within five years of being diagnosed with breast cancer, rectal cancer, colon cancer, pancreatic cancer and lung cancer, although it has started to improve in recent years. It is the third worst performer in managing amenable (i.e. preventable) mortality. It has an above average perinatal and neonatal mortality rate, standing at seven in 1,000 compared with the average of 5.5 in comparator countries.

Commentators have noted that the NHS performs this well despite having lower than average numbers of all types of staff besides midwives. It has one doctor for every 356 people, compared with the average of comparator countries of a doctor for every 277 people. The NHS has the lowest number of MRI and CT scanners per patient of all the systems considered.

Nigel Edwards, Chief Executive of the Nuffield Trust, referred to media coverage of NHS performance saying that “Discussion about the NHS is often marked by an unhelpful degree of exaggeration” while noting that the NHS is run “with very scarce resources” and achieves “poor outcomes in some vital areas like cancer survival.” Paul Johnson, Director of the Institute for Fiscal Studies, said that while “access is good and people are protected from high costs […] too many people in the UK die when good medical care could have saved their lives.” Dr Jennifer Dixon, Chief Executive of the Health Foundation said that “austerity has bitten hard, and the lag of investment shows.”