This week, NHS England has appointed a new medical director to replace Sir Bruce Keogh following the announcement of his departure in April. Professor Steve Powis, who is currently medical director at the Royal Free Foundation Trust, was described by Sir Bruce as “a standard bearer for clinical excellence, professionalism and patient centred care.” It is not yet clear when Professor Powis will take up the role.
Elsewhere, the think tank Reform has published a report on the devolution of public-services commissioning, which calls for devolution in England to be “drastically accelerated” and to cover healthcare, employment services and offender management services under one devolved budget. The report calls for NHS England to be scrapped and 95% of its budget, equating to more than £100 billion, to be devolved to 38 “super councils”. It stipulates that: “The centre must take a light-touch approach by setting high-level outcomes, for local commissioners to tailor to their areas. International moves to a more devolved state suggest this can be completed in 15 years, with the right support.”
Parliamentary written questions tabled on prescribing in primary care
The Labour MP Steve McCabe has tabled several written parliamentary questions on NHS England’s recent consultation on ‘items which should not routinely be prescribed in primary care’. McCabe’s question focused on the impact of the proposals on: patients with inflammatory bowel disease and other long-term conditions; the management of urgent care services and hospital admissions; and access to medications for children, older people and other vulnerable people. He also asked what the implications would be for patients with a long-term condition who have already purchased prescription prepayment certificates; and for the “medicine-taking behaviour of patients who rely on regular and multiple medications to prevent symptoms of long-term conditions.”
Primary Care Minister Steve Brine responded that the consultation sought to “ensure that the NHS is able to secure best value from its use of medicines and therefore focuses on areas of prescribing that have been found to be ineffective or where there are more cost effective alternatives.” He also said that NHS England will carefully consider the responses submitted to the consultation, “both to ensure that particular groups of people are not disproportionately affected and that principles of bets practice on clinical prescribing are adhered to.”
WellChild warns of growing pressures on children’s nursing
WellChild, the charity for seriously ill children, has published its annual impact report which warns that demand for specialist children’s nursing services is putting growing pressure on its network. The charity warns that there has been nearly a 40% growth in demand for its network of paediatric nurses over the last year, as well as a 37% increase in a nurse’s average caseload and an 82% increase to its ‘Helping Hands’ scheme over the same period.
The report calls for investment in the children’s community nurse workforce and in access to support services such as short break respite care. The charity’s Chief Executive, Colin Dyer, suggested that there is not adequate attention given to children and young people “living with serious and exceptional health needs”, despite a similar focus on adult social care.
Simon Stevens calls for additional NHS funding
The chief executive of NHS England, Simon Stevens, has made a call for additional funding to be allocated to the NHS in the upcoming Budget. Stevens also suggested that “trust in democratic politics” will be compromised if the Vote Leave’s pledge of an additional £350 million a week for the NHS after Brexit is not delivered.
He made the call for more funding at the NHS Providers annual conference in a speech that was not briefed to the Health Secretary beforehand, and argued that planned improvements to cancer and mental health care will not materialise without further funding. He also controversially suggested that performance targets will have to be abolished under current funding arrangements, as waiting lists will soar without investment and achievement against targets will go back “a decade” if nothing is done.
In his own speech to the conference, Jeremy Hunt agreed that the NHS needs more money, but indicated that the Chancellor does not think the same, saying he has repeatedly made and “must win” the argument for more funding. Hunt simultaneously emphasised the need for the NHS to find further efficiency savings to earn additional funds Hunt said that more funding overall – and increases to NHS staff pay – will depend on the overall economic situation and long-term productivity gains from the service.
Responding to the statements, the shadow health secretary Jonathan Ashworth said that Stevens was right to “set out in the clearest terms the stark implications of failing to give the NHS the funding it needs.”
Three health charities call for £4 billion more NHS funding
The Health Foundation, the King’s Fund and the Nuffield Trust have come together to call for £4 billion more funding for the NHS, as “current spending plans fall well short of what the NHS needs based on an assessment of Office of Budget Responsibility projections and historic rates of funding growth.” In a joint briefing, the health charities warn that the current NHS funding settlement will lead to funding per person falling by 0.3% in 2018/19, despite a pledge from the Government to increase NHS spending in real terms during every year of this parliament. The analysis also warns that there could be a funding gap of at least £20 billion by 2022/23, despite the Five Year Forward View intending to eliminate any funding gap through efficiencies and funding increases by 2020/21.
Commenting on the briefing, the Chief Executive of the Nuffield Trust Nigel Edwards said that NHS funding issues will not be addressed with “one-off bungs or bailouts”, and called on the Government to “face facts and commit to sustainable increases over the lifetime of this parliament.” The Chief Executive of the Health Foundation Jennifer Dixon also warned that the NHS risked falling below European standards without additional funding, and said that “An extra £4 billion in 2018/19 would simply be a return to the average increases of the first 63 years of the NHS’s history. The additional funding required is not exceptional, it is the last 7 years of austerity that are the exception.”
Seven CCGs to merge into two new bodies
NHS England has approved the merger of seven CCGs into two new CCGs, Berkshire West CCG and East Berkshire CC. The CCGs forming Berkshire West CCG will be Newbury & District CCG, North & West Reading CCG, South Reading CCG and Wokingham CCG, and the CCGs forming Berkshire East CCG will be Bracknell & Ascot CCG, Slough CCG, Windsor, Ascot & Maidenhead CCG. The former have already signed a memorandum of understanding to create the Berkshire West accountable care system (ACS), while the latter are all part of the Frimley Health STP and ACS.