Political and Parliamentary Monitoring
Week Commencing 3rd December 2018
The number of people accepted onto nursing courses in England continued to fall in 2018, despite the fact UK-wide acceptance rates hit a record high, the latest university application figures show. A new report by the Universities and College Admissions Service (UCAS) shows that number of applicants from England being accepted on nursing courses fell by 1.4% over the last year. This is the first time ever that acceptance rates have fallen two years in a row.
At the same time, the number of applicants to nursing courses across the UK declined for the second year running, with a 7.6 per cent decrease in 2018 on the back of 17.6 per cent drop the year before. Despite this fall in the overall number of applicants, places on nursing courses continued to be over-subscribed. In contrast to England, the number of acceptances in Scotland and Wales, two countries which unlike the Department of Health & Social Care in England, decided to retain bursaries for nursing students.
The Council of Deans of Health, which represents universities providing nursing, midwifery and allied health professional courses, said it was concerned about the decline, with its Executive Director, Katerina Kolyva, saying it showed the need for “urgent” steps to boost student numbers. Last month, Health Minister, Stephen Hammond MP, indicated that the Government may be wiling to consider reintroducing bursaries or a new system of grants in England.
- NHS funding hike must bring permanent end to GP crisis, says Chair
- Cuts to public-health short-sighted, according to BMJ study
- Secretary of State to consider safe staffing law in England
Secretary of State to consider safe staffing law in England
Matt Hancock, the Health and Social Care Secretary, has said he will look at the possibility of introducing safe nurse staffing legislation, it has been revealed. It is believed the first time a minister in England has openly said they are willing to look into the idea of enshrining safe staffing in law, with the Government have previously opposed such a move. The comments by the Secretary of State also come after a similar was introduced in Wales.
Speaking to members of the Royal College of Nursing (RCN), Mr Hancock said he would be “very happy” to look at proposals to introduce safe staffing laws. The admission comes after the RCN ran a high-profile campaign to call for legal minimum safeguards in the face of rising demand for services, falling numbers of staff, and rising vacancies. The law, as envisioned by the RCN, would make it mandatory for healthcare providers to have sufficient nurses on shift or available on projects to ensure patient safety.
Dame Donna Kinnair, acting Chief Executive and General Secretary of the RCN, welcomed the comments from Mr Hancock, saying that Mr Hancock was “right to make the workforce a top priority for a sustainable NHS”. Mr Hancock had attended the RCN summit to launch a new Government strategy to reduce violence against NHS workers.
Whilst the Secretary of State’s comments will be welcomed by the PCF, it raises several questions. It is unclear about whether it would apply to all nurses, or just those in A&E, and how the NHS would operate should it fail to meet the ‘safe standard’. As more details are released, the Secretariat will engage with inform the PCF of developments.
NHS spending on public health creating a postcode lottery of support
A new report published in the BMJ has highlighted that cuts to preventive health budget have affected some local authority activities more than others. Looking at the history of public health spending, the report examines the impact of reductions in spending by the Heath Service centrally, as well as local authorities, comparing spending in the decade 2000-2010 with 2010-2018.
Less emphasis is being put on public health now than at any point since Derek Wanless released his report in 2002, which placed the spotlight firmly on changing behaviours and improving public health with the aim averting more costly interventions at a later date. Since then, public health spending by central government has been scaled back greatly, with local authorities having bigger control over public health measures.
This, the BMJ article notes, has resulted in a postcode lottery with some councils allocating more funding to public health than others, and with the Local Government Association (LGA), which represents local authorities to central government, warning that some authorities are “salami slicing” services or digging into case reserves to make ends meet. “Some local authorities [are] showing they can cope better with austerity [than others]” the LGA says, adding that changing demographics and rising demand for services is increasing costs.
This report by the BMJ will further support the PCF’s calls for a review of how public health funding is allocated. Local authorities oversee school nurse funding, a health sector which has seen reductions in funding and provision over the last eight years.
Ofsted condemns ‘disjointed’ disability provision
Ofsted, the schools’ watchdog, has delivered a damning indictment of the education of children with special educational needs and disabilities. In her second annual report, the Chief Inspector of England’s schools, Amanda Spielman, warned that provision for pupils with SEND was often “disjointed and inconsistent”, with thousands missing out on vital support.
Her report, which captures the state of education in England, criticised the fact it took too long for many young people with special educational needs diagnoses, thus preventing them and their families accessing vital support. Her report highlights concerns around the step rise in the number of Education and Health Care Plans being delayed or refused. In 2017, there were 14,600 refusals by local authorities to carry out assessments, a third more than two years earlier.
The report also flagged the growing postcode lottery and disparity in the amount of provision and care offered by different local authorities, with a widening gap in performance and outcomes between the best and the worst local areas. Of the 68 inspections of SEND sites, there were serious failings in 30. Addressing an audience of education professional and policy experts in Westminster at the launch of her report, Spielman said that “there are still children who lag behind. Children for whom it seems the die is cast, even before entering nursery, and who never catch up in 12 years of schooling.”
Commenting on the report, a spokesperson for the Department for Education, said that the report also recognised that England has a “robust education system” where “parents can feel assured that the vast majority of schools, early years providers, children’s homes and local authorities provide a high level of education and care for young people, regardless of their circumstances.”
The Paediatric Continence Forum will be concerned about the findings of Ofsted’s annual report. Children with bladder and bowel issues and recognised disabilities linked to urology and continence issues are evidently not getting the support needed. If the PCF agrees, the Secretariat will engage with the schools’ regulator about the need to provide adequate support and facilities for those with disabilities.