This week, the Government announced a £1.3 billion plan to improve mental health services. The Health Secretary, Jeremy Hunt, said that 21,000 new posts would be created to facilitate more specialist nurses, therapists, psychiatrist, and peer support workers among other mental health professionals. The announcement received a mixed response from mental health campaigners and workforce bodies, with the British Medical Association welcoming the focus on psychiatric services and the Royal College of Nursing questioning the timeframe for training and saying the numbers “appear not to add up”.
Meanwhile, the Cabinet has continued to air its differing views on Brexit, with several ministers arguing for a soft transitional arrangement after March 2019 allowing for continued freedom of movement. Amber Rudd, Phillip Hammond and Jeremy Hunt have all publicly discussed the benefits of retaining ease of movement for EU citizens seeking to work in the UK over the past week, while the International Trade Secretary, Liam Fox, argued such arrangements would be a betrayal of the referendum result. A spokesperson for Number 10 sought to clarify the Government’s position by saying “it would be wrong to suggest (free movement and immigration) will continue as it is now.”
Concerns raised over Scottish nursing workforce
Audit Scotland, the auditing body for the public sector in Scotland, has warned that the Scottish Government has not made sufficient long-term planning arrangements for its nursing workforce. A report produced by Audit Scotland has suggested that if all Scottish nurses eligible to retire at 60 over the next five years do so, there will be a 9.6% shortfall in the number of nurses against the number of newly-qualified nurses coming into the sector. The report also highlights that the number of newly-qualified nurses fell by 15% in 2014/15 and 7% in 2015/16, skewing the proportion of nurses aged over
This looming shortfall has been linked with rising workloads, with nine in ten Scottish nurses surveyed
by the Royal College of Nursing reporting that their workload has increased recently. The auditor
general for Scotland, Caroline Garnder, commended the Scottish Govenrment for recognisning the
problem, but said they “urgently need to improve their understanding of future demand, staff projections and associated costs, and set out in detail how they plan to create a workforce that can meet the longterm health needs of the population.” The Royal College of Nursing in Scotland said that the Scottish government had failed to “future proof” the Scottish NHS workforce.
Report highlights NHS waste and danger of “political” targets
An internal audit on clinical efficiency in the NHS has found large variations in the cost and quality of
care across England, highlighting the need for health organisations to significantly reduce waste in
general surgery. Professor Tim Briggs, the national director of clinical quality and efficiency at NHS
Improvement, led the audit as part of the Getting It Right First Time (GIRFT) programme, which seeks
to improve care in the NHS by reducing variations in service. The report outlines a number of clinical
procedures and treatments across the country where trusts are spending vastly different amounts for
products, and where substantially different results are being delivered for patients. For example, death
rates from bowel cancer surgery vary from zero to 14%, and some hospitals are paying 350 times more
than others for basic surgical equipment.
Professor Briggs says that the findings show there are “huge” efficiency and performance gains to be
made across the system, and argues that this should take priority over increasing funding for the NHS.
He told The Times that the NHS does not deserve more money, “until we put our house in order and
we actually make the changes that will improve quality of care.”
While not outlining a need for more money, the report criticised what its authors deemed to be
“politically derived measures” reducing the quality of care delivered to patients. Specifically, it
mentioned data collecting surgeon-specific mortality rates having the potential to create “clear perverse
incentives”, by disincentivising high-risk operations. The authors also highlighted cancer waiting times
targets as “not clinically driven or motivated”, suggesting that they “may even inadvertently result in
reducing the quality of care patients receive”. In a pre-prepared statement, Jeremy Hunt said that “by
reducing variation we can improve care and eliminate waste at the same time”, but the Department of
Health did not specifically respond to the issue of targets when approached by HSJ.
NHS procurement savings scheme falls behind schedule
It has been reported that the Nationally Contracted Products (NCP) programme, which is intended to agree prices on everyday products purchased by the NHS, is behind schedule on agreeing prices for some products, while being “broadly on track”. NHS Improvement, which is driving the programme, had intended for 12 product lines to have centrally-decided prices by the end of this year and is still aiming to decide prices for 14 categories in that time. However, the intention for this to cover more than 100 products does not seem to be progressing at pace, with only two products being made available to NHS providers.
The categories of product which will be covered by the programme include examination gloves, wipes, syringes and needles, with the hope that 25% savings could be made if all trusts across the country paid the same price for these products. NHS Improvement suggested during discussions with HSJ that procurement of other products had been delayed as “macroeconomic factors such as currency fluctuations can also determine the optimum time for a particular procurement”.
Brexit Healthcare Alliance publishes five priorities to safeguard UK health sector
The Brexit Healthcare Alliance, representing a range of organisations working to ensure specific healthcare issues are given prominence during Brexit negotiations, has published a list of five priorities needed to protect UK healthcare during the process. The Alliance differs from the Cavendish Coalition, which specifically focuses on Brexit-related workforce issues in health and social care, and intends to prioritise:
- Ensuring maximum levels of research and innovation collaboration
- Providing regulatory alignment for the benefit of patients and population health
- Preservation of reciprocal healthcare arrangements
- Robust coordination mechanisms on public health and wellbeing
- Securing a strong funding commitment to the health and public health sectors
Organisations represented in the Alliance include the Academy of Medical Royal Colleges, the Association of British Healthcare Industries, the NHS Confederation and representatives from the devolved nations.