The struggles of the NHS have featured prominently in the media this week, after it emerged that the number of patients facing “long waits” for routine operations rose by 163% in four years. Nine in ten hospitals have also had unsafe numbers of patients on their wards this winter; and record numbers of patients have waited more than four hours in A&E. Speaking in a BBC interview at the end of the week, Health Secretary Jeremy Hunt said there is “no excuse” for some of these problems, and that it was vital to treat more people “at home and in the community” to ease the burden on hospitals. He highlighted the Sustainability and Transformation programme already under way, but conceded that this could take time.

Mr Hunt’s comments on NHS transformation arrived after the Royal College of GPs (RCGP) published its interim assessment of the GP Forward View (GPFV), which determines that STPs have not given sufficient recognition to the funds or efforts needed by general practice to implement required changes. The College states that many STPs “fail to cover the GP Forward View in any detail” despite its importance to supporting general practice and thereby delivering the intentions of the STPs. The report further highlights that “alarmingly, a number of STPs appear to plan for a reduction in the number of GPs, contrary to the vision of the [GPFV]” and calls on the Government, NHS England and STP footprint leaders to prioritise the implementation of the GPFV.

Finally, the Times reported that the Government is planning to merge the Nursing and Midwifery Council (NMC) and General Medical Council (GMC) into one “super-regulator”, as part of a major overhaul of professional regulation. A consultation on the Government’s proposed reforms is expected within the next two months.

Government planning to merge NMC and GMC

The Government is planning an overhaul of professional regulation that would see the Nursing and Midwifery Council (NMC) and General Medical Council (GMC) merged to form a super-regulator covering more than a million staff, according to a report in the Times this week. Under the current system, the NMC is one of nine regulators overseeing healthcare professionals, with each having separate standards, codes of conduct and investigatory methods. These range from the NMC, which regulates more than 600,000 nurses and midwives, to the General Chiropractic Council, which regulates just 3,000 practitioners.

Concern has been mounting that this system is confusing for patients, after a public inquiry into the neglect of hundreds of patients at the Mid Staffordshire trust found that the system was too fragmented to spot emerging scandals. The fear is that the dispersion of regulatory authority has resulted in people not knowing where to complain when they have been mistreated by health professionals.

Ministers are said to be considering a number of options to resolve this issue. Under one option, the nine regulators would merge to form one organisation, which would register all health professionals and carry out disciplinary procedures. Under an alternative option, the GMC and NMC would merge into a core regulator, while dentists’, pharmacists’ and opticians’ regulators would combine to form a “High Street health” regulator. A third body would then cover professions such as podiatrists, osteopaths and physiotherapists.

The news of the Government’s plans follows the second reading debate of the Regulation of Health and Social Care Professionals Bill. This is a Private Member’s Bill introduced by Labour Shadow Health Spokesperson Lord Hunt, who hopes to make the Government bring the legislation covering healthcare professionals together under one legislative framework. During the debate, Lord Hunt criticised the Government’s lack of action around regulation of healthcare professionals, despite previously accepting the recommendations of a Law Commission review on this subject. In response, Government Whip Baroness Goldie announced that the Government will consult on “radical reforms of professional regulation across the UK” within the next two months.

Minister answers parliamentary question on Changing Places toilet facilities

SNP MP Richard Arkless has received an answer to his written parliamentary question on the Changing Places toilet facilities. His question asked whether the Department for Communities and Local Government (DCLG) has assessed the potential merits of Changing Places toilet facilities in public places, and whether it will include requirements for such facilities in any future disability strategy.

DCLG Minister Gavin Barwell responded that the Government supports steps to increase the number of Changing Places toilets. He said that “Research into the effectiveness of the guidance which supports Building Regulations’ requirements for access for non-domestic buildings is currently being finalised”, and that this covers the provision of Changing Places toilets. He said the research will be published in due course and that the Government will consider carefully any findings relating to Changing Places toilets.

PHE pilots online space on Knowledge Hub

Public Health England (PHE) is piloting a space on knowledge-sharing website Knowledge Hub to share information about local public health knowledge and intelligence products and services. Knowledge Hub is the UK’s largest platform for public services, and will provide geographical PHE Centres with a means of helping partners to keep up to date with health intelligence in their area and take part in discussions.
PHE’s space on Knowledge Hub will feature:

  • Information about PHE’s local knowledge and intelligence service, including local health intelligence reports and analysis, newsletters and signposting guides;
  • Opportunities to participate in discussion forums and share information; and
  • Links to other PHE intelligence tools and resources

To join the Knowledge Hub, it is necessary to open an account and register with a local group.

NAO criticises lack of progress in health and social care integration

The National Audit Office (NAO) has warned that progress in health and social integration has been slower than envisaged and has not delivered all the expected benefits for patients, the NHS or local authorities. As a result, it argued that the Government’s plan for integrated health and social care services across England by 2020 is at “significant risk”.

The NAO said the Better Care Fund, the Government’s main integration tool for health and social care, had improved joint working but failed to achieve its potential as a result of increased demand for care and constrained finances. The fund had a £5.3 billion budget to encourage the NHS and councils to work more closely together, but the NAO found that it had failed to achieve the expected value for money, in terms of savings, outcomes for patients or reduced hospital activity.

The NAO also criticised the “vanguard” sites proceeding under the Sustainability and Transformation process. It concluded that NHS England’s ambition to save £900 million through introducing seven new care models “may be optimistic”, as their impacts are still being evaluated. It noted that an array of initiatives are examining options for transforming care and creating a financially sustainable care system, but said these suffer from poor governance and oversight.