This week, the Department of Health has announced a consultation on the regulation of medical associates, covering physician associates, physicians’ assistants (anesthesia), surgical care practitioners and advanced critical care practitioners. The consultation wants to seek views on the introduction of statutory regulation for these professions and how proportionate these would be, in light of the Government’s ambition for 1,000 physicians’ associates to work within general practice by 2020.

Parliamentary questions on Excellence in Continence Care guidance answered

Labour MP Mark Hendrick received answers to two written questions on the Excellence in Continence Care Guidance from Public Health Minister Steve Brine. Hendrick asked what progress the Department of Health had made, on measuring reductions in inappropriate or unnecessary catheterisation and catheter associated UTIs, and what statistics there were to demonstrate this; what progress has been made in reducing the number of prescriptions for catheters, out-patient appointments, surgical interventions, and costs relating to pads and other incontinence products. Answering both questions, Brine said that the information is not collected centrally, and did not provide any further information.

Conflicting messages on NHS pay rises

During the first session of Health Questions since the conference recess, the Health Secretary Jeremy Hunt seemed to announce an end to the public sector pay cap. Following protracted campaigning from health unions and the abandonment of the cap for police and prison officers, Hunt had confirmed it would be removed for NHS staff too. However, Hunt then said that “the latitude that the Chancellor has given me with respect to the negotiation of future pay rises is partly linked to productivity improvements that we will negotiate at the same time.”

However, Simon Stevens of NHS England and Jim Mackey of NHS Improvement then told the Health Select Committee that an end to the pay cap could not be funded from further NHS efficiencies. Stevens commented that “We have said from the get go that over time it will be necessary for NHS staff to get rates of pay that are consistent with the rest of the economy. That does need to be funded.” Stevens also said during the evidence session that the decisions taken on NHS funding in the Budget “will determine the shape of the NHS next year and the year after”, indicating that he may have advocated for further funding to ease the funding constraints predicted for 2018/19 and 2019/20.

King’s Fund publishes analysis of nursing workforce statistics

The King’s Fund has published analysis of nursing workforce statistics published by NHS Digital, and has warned that the number of nurses working in the NHS has fallen over the last three months, even when accounting for seasonal fluctuations. The analysis looked back at previous levels of recruitment to the nursing workforce, which averaged 2.3% between 2000 and 2010, before declining between 2011 and 2013 and then increasing again in the wake of the Mid Staffs scandal.

Despite this trend, the number of nurses has fallen over the last three months. The author – the King’s Fund’s director of policy, Richard Murray – argues that a correlation can be drawn between the recent decline and the outcome of the EU referendum, saying “the UK is no longer quite so attractive a destination for clinical staff for obvious reasons.” The chief executive of the Royal College of Nursing, Janet Davies, called for “a new law that makes ministers and others accountable for proper workforce planning and safe and effective staffing levels.”

“Too late” for NHS winter cash injection

The chief executive of the NHS Confederation, Niall Dickson, has written in the Times that a sudden cash injection is unlikely to solve the forthcoming winter pressures on the NHS, and has called on the Government to “revisit the penciled-in figures for 2018/19 and 2019/20” to avoid future crises. Senior NHS figures have repeatedly raised concerns that the potential for a winter flu epidemic is worrying hospitals, and Dickson says that to prevent this from putting pressure on hospitals there needs to be “effective planning and good co-operation across the entire health and social care system, but there is only so much that can be done.” His piece is accompanied by figures suggesting that 92% of healthcare leaders polled by NHS Confederation are concerned about their ability to handle winter pressure.

Brexit negotiations reach “disturbing” deadlock

The UK and EU negotiating teams have held their monthly press conference updating on the state of Brexit negotiations, with the EU’s chief negotiator Michel Barnier concluding that there has been insufficient progress on the first stage of talks to progress to the next stage. The European Council is due to meet next week and was set to decide whether to move on to discussions on the future trading relationship between the UK and the EU, but without this proposition from Barnier, the decision will be delayed until a future meeting.

Barnier made clear that an impasse has been reached because the UK has not made a firm offer on how much it would pay to the EU, stating “On this question we have reached a state of deadlock which is very disturbing for thousands of project promoters in Europe and it’s disturbing also for taxpayers.” However, it was subsequently reported that the remaining member states are set to discuss the future trade relationship without involving the UK. The EU did recognise progress on the Northern Ireland border, while the Brexit Secretary David Davis pointed to developments on citizens’ rights, by clarifying that processes for EU citizens to register with UK authorities will be streamlined.

It is little surprise to those in Brussels that Barnier does not want to progress to the next stage of negotiations. The Government has also had to postpone the next stage of debate on the European Union (Withdrawal) Bill which had been due to take place next week due to the number of amendments tabled. 300 amendments have reportedly been tabled, and Labour claims that at least a dozen of these could be supported by rebellious Conservatives. Such a degree of hostility would make the debate difficult for the Government, given the previous statements from Remain-supporting Conservatives that they were passing the Bill at second reading only if the Government accepted concessions at a later stage.