This week, the Welsh Government has published an interim report on its Review of Health and Social Care in Wales, highlighting the need for significant transformation to health and social care services. The Chairs of Select Committees in the House of Commons have been elected, and the House of Lords has held a debate on the public sector pay cap. NICE has published minor changes to its guideline on constipation in children and young people, and the King’s Fund has warned in analysis of public health budgets that services now face real-terms cuts.

Welsh Government publishes interim report on Review of Health and Social Care

The Welsh Government has published an interim report for its Parliamentary Review of Health and Social Care in Wales, with initial conclusions stating that health and social care services “have to change” through the implementation of new models of care. The report recommends that Welsh people, staff, service users and carers should have “greater influence on new models of care with clearer, shared roles and responsibilities”, while new skills and career paths should be developed for health and social care workers, and technology and infrastructure used in a higher quality and more efficient manner.

The report recognises that while steps could be taken now to increase primary and community care funding and grow the number of GPs, “these are not likely to be sustainable, and additional measures will be required to close the gap between need and capacity.” Although focusing on care for older patients and those with comorbidities, the report advocates for “expanded roles for other professional care groups” and “better care co-ordination and integration for people with multiple health and social care needs.” It also described community services as “the poor relation of other services”. Responding to the report, the Royal College of GPs Wales said that “Building on the existing strengths of general practice and developing new models of care will allow our healthcare services to adapt”, and expressed its willingness to work with the Welsh Government on the review over the coming months.

House of Commons’ Select Committee Chairs elected

Elections for Select Committee Chairs have taken place in the House of Commons this week, with Robert Halfon succeeding in being elected chair of the Education Select Committee. Halfon was the Minister of State for Apprenticeships and Skills until Theresa May’s reshuffle in June, and was competing against Nick Boles, Rehman Christi, Tim Loughton, Stephen Metcalfe and Dan Poulter for the position. He is widely respected in the further education community, which his work as a minister focused on, and many stakeholders were disappointed when he was sacked as a minister.

As confirmed last week, Sarah Wollaston was re-elected unopposed as Chair of the Health Select Committee, while Meg Hillier was returned as Chair of the Public Accounts Committee. The selection of members of committees was not expected to be completed before the autumn, although it has been reported that Labour members of the Treasury Committee have been chosen already.

House of Lords debates public sector pay cap

Members of the House of Lords have debated the possibility of a review of the public sector pay cap in the wake of a letter asking the Prime Minister to re-evaluate it in light of growing public concern. The debate was initiated by the Labour peer Lord Haskell, who said that the public feels “awkward” and “hypocritical” when realising that “because of pay restraint, [the earnings of public sector workers] have effectively decreased in recent years”. Lord Haskell also referenced the contradictory positions within the Cabinet on pay restraint, with the Chancellor “taking a firmer, more rigid view” on maintaining the policy.

The debate was preceded by a letter to the Prime Minister from peers protesting the continuation of the cap, saying that “Even though health care professionals deliver care to the best of their ability, patient care and safety is inevitably compromised when hospitals and other care settings are short of staff.” The chief executive of the RCN, Janet Davies, labelled the pay cap “unsustainable” and highlighted the growing group of parliamentarians supporting its removal – she also met with the SNP’s Westminster Health spokesperson Dr Philippa Whitford this week to discuss the issue.

NICE publishes minor changes to guideline on constipation in children and young people

NICE has marginally changed its guideline on constipation in children and young people: diagnosis and management, following its consultation on the guideline in June. The changes were to update two footnotes in the guideline to include a new NICE guideline on coeliac disease and altered manufacturer information.

However, beyond this, NICE has decided that no new evidence had been presented that affects the recommendations in the guideline, and so would not update the guideline at this point. The publication of the update stated that evidence on transanal irrigation was identified by the review, but was “considered to be insufficient in volume and conclusive results to add new recommendations at this time.”

King’s Fund publishes analysis of public health budgets

The King’s Fund has published analysis of local authorities’ public health budgets for 2017/18, drawing comparisons with budgets since 2013/14. Taking into consideration the transfer of children’s 0-5 services to public health budgets and inflation, public health spending was £2.52 billion in 2016/17 against £2.51 billion in 2013/14, which equates to 5% less funding in real terms over this period. The analysis concludes “there is little doubt that we are now entering the realms of real reductions in public health services. This is a direct result of the reduced priority that central government gives to public health.”

The report particularly expressed concerns at the reductions in sexual health, smoking cessation and drug treatment services, which the author David Buck warned is “the falsest of false economies.” The Local Government Association said that “Local authorities were eager to pick up the mantle of public health four years ago, but many will now feel that they have been handed all of the responsibility, but without the appropriate resources to do so.”