Weekly political news round up – 4th November 2016

November 4, 2016 in News by Whitehouse

Overview

This week in Parliament, the Chairs of the Health Committee and Public Accounts Committee challenged the “£10 billion” figure that the NHS will supposedly receive by 2020-2021; and the House of Commons debated chronic urinary tract infections. Outside of Parliament, a GP Online article gave an in-depth account of managing, treating and referring paediatric bed-wetting; and Dr Penny Dobson, Chair of the PCF, blogged about continence problems for Public Health England’s week of action on continence. Finally, the Nursing Times reported on increasing concerns over the Department of Health’s new nursing advisory post.

The PCF has also launched its own Twitter account this week, under the username @PaedContForum. Using the Twitter account will present us with an opportunity to engage with supporters and policymakers, and raise further awareness of paediatric continence issues. If you use Twitter, please do take a look at our account and follow us!

Parliamentary and political developments

Chairs of Health Committee and Public Accounts Committee challenge government statements on NHS spending

The Health Committee has written to the Chancellor of the Exchequer this week, asking the Government three questions on NHS funding. Alongside questions on social care and capital resources, the Committee asked whether the Government will “look at the NHS funding settlement for the middle years of the Spending Review, and commit to providing the resources the health services needs to meet rising demand”. The Committee also said that the Government’s claim it has provided an additional “£10 billion for the NHS” is misleading when scrutinised, because it can only be reached when an additional year is added to the spending review period. The Chair of the Committee, Dr Sarah Wollaston MP, argued that part of the increase in funding to NHS England is offset by reductions in funding in other areas of health spending. This means that between 2015/16 and 2020/21,
the Department of Health’s budget will only increase by £4.5 billion.

Additionally, Meg Hillier MP, in her capacity as Chair of the Public Accounts Select Committee, has also written to the Prime Minister this week expressing the committee’s concern about the NHS budget. Ms Hillier explained that she is “dismayed” that the Government denied that there is a problem with NHS finances in its response to Dr Wollaston, despite the large body of evidence suggesting otherwise. The letter states that the mismatch between resources and patient demand has been predicted by NHS Improvement, NHS England and other independent analysts, and it has been widely recognised that the 4% a year efficiency saving from the NHS budget is unsustainable.

Chronic urinary tract infections debated in the House of Commons

Catherine West MP, Shadow Minister for Foreign and Commonwealth Affairs, secured an adjournment debate on Friday on the inadequacies of current tests for chronic urinary tract infections in the House of Commons Chamber. Ms West highlighted that “dipstick tests” have been used for 60 years and are known to be deficient, yet guidelines have not changed. Ms West’s constituency of Hornsey and Wood Green is home to Professor Malone-Lee’s clinical research in diagnosing chronic UTIs, and concerns were raised throughout the debate on the future of his integral work, which is currently being review by the Royal College of Physicians. She asked Nicola Blackwood, Parliamentary Under-Secretary of State for Health, the following questions:

  • Will she meet with Ms West and other MPs concerned about the ineffectiveness of existing guidelines to
    discuss the matter in more detail; and
  • Will she agree to have a meeting with representatives from patient groups.

]In her response, the Health Minister acknowledged the importance of the subject raised by Ms West and welcomed the Labour Party leader Jeremy Corbyn to the debate (although the latter did not speak). She described how current NICE guidelines have not yet addressed the issues of UTI detection that has been raised by Professor Malone-Lee, but NICE has been asked to consider his work when next reviewing UTI guidance. Ms Blackwood also agreed to meet with both interested MPs and patient representative groups to discuss the issue further.

Clinical developments

GP Online reports on managing nocturnal enuresis

GP Online has published an article this week on the prevalence of nocturnal enuresis; contributing factors to its development; and useful interventions in primary care. It stresses differentiating between primary monosymptomatic nocturnal enuresis (PMNE) and nocturnal enuresis (NE) with associated daytime symptoms, as the former means the bedwetting is an isolated symptom of bladder dysfunction.

The article lists many different causes of night-time bedwetting, including a functionally small capacity bladder and family histories, with the chance of a child having an overactive bladder rising to 77% if both parents have previously been affected by the same condition. To treat NE, it advises that addressing daytime symptoms can help resolve night-time problems, alongside charting a child’s sleep patterns and medicinal intake.

Management of PMNE does not usually start until a child is seven years of age, and it is usually based on the underlying causes of the incontinence problem. For NE treatment, the article states that motivation levels of a child can be significant; for children above the age of ten, NE may cause psychological problems; and that the medicine nocturnal plyuria can increase success rates by 60%.
For children who cannot be treated in primary care, they should be referred to community enuresis clinics or hospital-cased specialists. Indications for referral include:

  • Daytime symptoms requirement further assessment;
  • Symptoms of bladder outlet obstruction;
  • Any other symptoms of bladder dysfunction, including recurrent UTIs; and
  • Children with intractable PMNE despite treatment.

PCF Chair blogs about continence problems for Public Health England week of action

The Chair of the PCF, Dr Penny Dobson, has written a blog post which has been published as part of Public Health England’s week of action on helping children with continence problems. In the post, Dr Dobson highlights the crucial role which school nurses play in assessing children with bladder and bowel problems and initiating first line treatment, as well as their ability to “break through the barriers” of embarrassment experienced by many of these children.

The post also references the work of Dr Katie Whale at the University of Bristol, whose detailed study of twenty children and young people with continence problems found that many try to hide their problems as part of the fear of being bullied if they were “found out”. Dr Dobson highlighted the need for properly commissioned and integrated paediatric continence services to help these children and young people and to avoid “the disruption and frustration families experience when going to separate clinics”.

Concerns raised about limitations of new government nursing post

Nursing and workforce experts have told the Nursing Times that the new nursing and midwifery post created in the Department of Health may not have the ability to provide the high-level advice required of the role to properly advise on government decisions. Despite the Government committing to creating the position in light of the disbandment of the nursing and midwifery advisory unit, the new post was labelled a “little victory”. Professor Jane Ball, nurse research fellow at Southampton University, said it would be cause for concern if the post is not “at least on the same level as the nursing officers who previously offered government advice”. Professor Ball also noted concerns about reducing the advisory capacity from a unit of seven people to a singular advisory post.