This week, NICE has published updated guidelines on urinary tract infections (UTIs) in children and young people. The first, guidance on urinary tract infection in under 16s: diagnosis and management, has had its named changed from ‘urinary tract infection in children: diagnosis, treatment and long-term management’, and includes changes to some recommendations on urine testing strategies for infants and children under 3 years. The second, a quality standard on urinary tract infection in children and young people, has been updated to ensure it is in line with the guidance on UTIs in under 16s and describes what high-quality care should look like in priority areas for improvement.
Elsewhere, the Department for Education has appointed Sir Theodore Agnew to be Academies Minister to replace Lord Nash. The shadow health and education secretaries have given keynote speeches at the Labour Party conference; and the GMB union has criticised the Government’s delay in lifting the public sector pay cap.
New Education Minister appointed
The Government has appointed a new minister to replace the Academies Minister Lord Nash, who is leaving government following his drive to implement the academies system since January 2013. The new minister will be Sir Theodore Agnew – who will be given a peerage to assume the role – who has previously sponsored the Inspiration Trust academy chain and chaired the academies board at the Department for Education. Sir Theodore has also previously worked with Michael Gove at both the Department for Education and the Ministry of Justice, and was a “leading candidate” for the chairmanship of Ofsted in 2014.
Lord Nash’s departure has been viewed by some as concerning for the further development of the academies programme, with one unnamed stakeholder commenting that he was “among the last of the old school of Gove-era ministerial education reformers.” Sir Theodore’s appointment has, however, been interpreted as an additional move away from the creation of new grammar schools, given that he has previously stated that he doesn’t believe in grammar schools, as failing the 11-plus exam made him that “I’m a second class citizen from this day.” He has also previously funded research by the centre-right think tank Policy Exchange which argued for the pupil premium for disadvantaged students.
Shadow health and education secretaries speak at Labour Party conference
The shadow health and education secretaries, Jonathan Ashworth and Angela Rayner, have given speeches to the Labour Party conference building on their party’s manifesto commitments. Ashworth reiterated the party’s commitment to an additional £45 billion in funding for health and social care, and used his speech to call for a £500 million winter fund for the NHS to assist with pressures on A&E departments. On child health, Ashworth said that Labour would “recruit more health visitors for our communities […] And we’ll end the disgraceful cuts to child and adolescent mental health budgets, end the scandal of children being treated on adult wards, and finally deliver true parity of esteem.”
Angela Rayner, who has been tipped as a future Labour leader, elaborated on the party’s manifesto commitment to a National Education Service; pledged to allocate £500 million a year to Sure Start centres; and “provide the full £13 billion needed for the existing school estate.” Jeremy Corbyn’s speech was set against a more united backdrop within the party than the previous year’s, and called for the Prime Minister to “make another impetuous decision” in calling another election.
Union criticises delay in lifting public sector pay cap
The trade union GMB has called on the Government to lift the public sector pay cap before the Autumn Budget on 22nd November. The recent announcement by the Government that police and prison officers would receive a pay increase was branded a “token gesture” by the union – given the speculation beforehand that the cap would be lifted for all public sector workers. GMB’s national secretary for public services, Rehana Azam, said that the Government “claims the pay freeze has been broken. Well, do not believe a word of it.”
Azam also highlighted that “over half of public sector workers are not even covered by independent pay review bodies”, meaning that the announcement would not apply to them. The comments came in the same week that the Royal College of Nursing warned that it would ballot its members on strike action if the pay cap is not lifted in the Budget, and said it would be looking to discuss the issue with Conservative MPs at next week’s party conference.
Nurses say NHS staff shortages causing patients to die alone
A Royal College of Nurses survey has revealed deep concerns among nurses about the impact of staff shortages in the NHS on seriously ill and vulnerable patients. This week the RCN canvassed 30,000 members – including midwives and health care support workers – with the survey revealing a range of issues for patients caused by a lack of time NHS staff were able to dedicate to individuals’ care.
The RCN described some of the stories it received through the survey as “desperately sad”, but “sadly all too familiar”. According to the BBC, there were reports of situations where patients had died alone, as their nurses and carers did not have time to cover all of their responsibilities. RCN general secretary Janet Davies said, “when this many professionals blow the whistle, they cannot be overlooked.” A spokeswoman for the Department of Health said that the numbers of nurses in training is increasing, and said there would be another 10,000 in the workforce by 2020. A report by the union earlier in the year found that one in nine existing posts are vacant, with the steep decline in the number of EU trained nurses applying to work in the UK since the EU referendum last year exacerbating the shortages.
King’s Fund warns that hospital bed closures go too far
The number of NHS hospital beds has been cut in half over the past 30 years, and a new report from the influential think-tank, the King’s Fund, has warned that proposed closures outlined through Sustainability and Transformation Plans are “neither desirable nor achievable”. The report shows that the number of hospitals beds per head of population in England is lower than that of any other EU country, at 2.3 per 1,000 people, as compared with the European average of 3.7 per 1,000.
The report’s author – Helen McKenna – said that while many historic bed cuts had been related to advancements in healthcare services, current proposals to reduce beds are so extreme that they may jeopardise patient safety, and seriously impact the quality of care within “hospitals already stretched to breaking point” as the NHS prepares for what is anticipated to be a difficult winter. An NHS England spokesman said that “work is underway to free up 3,000 more (beds) by improving the availability of community health and social care”, while saying that the national commissioner has “introduced an explicit test to prevent inappropriate bed closures.”
NICE updates guidance on urine testing for children
NICE has issued an update to its clinical guidance on urine testing, in the review of its guidelines for Urinary tract infection in under 16s: diagnosis and management. The Committee, which approved the changes to the existing guidelines first developed in 2007, changed the specific guidance for urine testing to recommend dipstick testing in infants and children aged 3 months or older but younger than 3 years. It also recommended referral to specialist paediatric care for all children under the age of 3 months, given concerns about sepsis in infants. The full explanation for the revisions to this guidance can be found here.