This week, the Department of Health announced that the NHS will become the first healthcare system in the world to publish statistics on avoidable deaths. The publication of such figures follows a Care Quality Commission report in 2016 which suggested that the NHS was “missing opportunities to learn from patient deaths” and failing to include families in investigations. Jeremy Hunt has since repeatedly insisted that the Government will do more to identify and tackle avoidable deaths, and on Thursday said the programme, “marks a significant milestone in ensuring the NHS learns from every tragic case… to prevent mistakes recurring and ultimately delivering safer care for all patients in the future.”
Earlier in the week, King’s College Hospital Trust Chair Bob Kerslake announced his resignation in a letter to the Guardian, citing underfunding and poor planning, and arguing, “the government… (is) simply not facing up to the enormous challenges that the NHS is currently facing.” Kerslake, having lead the civil service and acted as chairman of one of the country’s largest Trusts, is a highly respected figure in the NHS but his organisation had come under fire from the departing NHS Improvement Chief Executive Jim Mackey, who claimed King’s wasn’t doing enough to reduce its deficit.
Teens need incontinence support at school – study
Research from the University of Bristol has concluded that teenagers with incontinence are at greater risk of underachieving academically, and need more educational support to reach their potential. In the only detailed qualitative study carried out in this area in the UK to date, academics at the University interviewed 20 young people with continence problems, aged from 11 to 19, and found that it was rare for young people to speak about continence problems at school to both friends and teachers, due to fears of being stigmatised, bullied or teased.
The study also identified a need to increase teachers’ awareness of continence problems in young people, and to provide guidance on how best to provide support at school. Its recommendations included providing unrestricted access to toilets during the school day for young people suffering from incontinence, and the researchers said they are “developing a prototype smartphone app to support young people to manage daytime urinary incontinence.” The researchers will work with ERIC and educators to produce online resources for secondary teachers. ERIC chief executive Juliette Randall said, “the powerful stories described in this research give us a strong basis for engaging with schools” to improve the experience of young people with continence issues.
HEE points finger at “millennials” for recruitment issues
Health Education England has launched a consultation on its draft strategy entitled Facing the Facts, Shaping the Future, A health and care workforce strategy for England to 2027 which outlines how the NHS will work to become a model employer over the next 10 years amidst a growing problem with staff recruitment and retention. It highlights that “the NHS is employing more staff now than at any time in its history”, and implies that a poor work ethic in “millennials” – or people considered to be part of Generation Y – is a cause of the healthcare staff recruitment crisis in the UK.
The strategy was reported in the Daily Telegraph under a headline specifically citing millennials demands for “shorter hours and gap years”. It outlines that the paper says the workforce will need to increase by a fifth to meet demand, unless productivity or measures to prevent ill health improve. The article quotes Professor Ian Cumming, Chief Executive of Health Education England, saying that millennials “see work-life balance as paramount” and “unlike previous generations they want to be able to adapt their work schedule to their home life and not the other way around.” He also argued that the increased number of women entering the profession means more staff have needed to be trained to cover the numbers of people working part-time.
The strategy proposes specific measures such as targeted retention schemes, improvements in medical training and support for junior doctors, and making the NHS a more inclusive, family-friendly employer. Emergency medicine is struggling most with staff recruitment and retention, with nearly 16 per cent of posts being vacant, closely followed by acute medical services with 14 per cent. Health Secretary Jeremy Hunt said that this strategy is the beginning of “a proper plan [for the NHS] that stretches beyond any electoral cycle,” while Professor Sir Malcolm Grant, Chair of NHS England, and Duncan Selbie, Chief Executive of Public Health England, both also welcomed the strategy.
The strategy also reveals rising turnover rates in the nursing workforce, with almost 9% of nurses leaving the NHS over the past 12 months, a steady rise from a 7.3% turnover rate in 2012-13. The document states that, “insufficient growth in supply, more retirements, and increased demand for staff are leading to greater competition between trusts for nurses.” The strategy also notes a particular workforce shortage issue with learning disability and mental health nurses, with the number of posts left empty this year at 16% and 14%, respectively. Ian Cumming said there are currently no specific targets for the nursing workforce over the next 10 years, but admitted that “we need more nurses in the mental health environment.”
The Royal College of Nursing welcomed the publication of the draft strategy saying, “the Government has acknowledged that the workforce crisis is the single most important issue facing health and social care today, and we look forward to working with ministers to find properly funded solutions.” However, RCN Chief Executive Janet Davies said the Government “must take responsibility for building a sustainable supply of domestic nurses” and also called on ministers to, “reverse cuts to vital funding for continuing professional development”, that were recently called into question in a Health Committee hearing.
The publication of the draft workforce strategy comes in the same week as the release of an RCN “Nursing Employment Survey”, which found that over a third of nursing staff (37%) report that they are looking for a new job, and close to two-thirds (63%) say they are too busy to provide the level of care that they would like.
Government suffers first defeat on the EU Withdrawal Bill
This week, the Government suffered its first defeat on the EU Withdrawal Bill as several Conservative MPs backed an amendment tabled by Dominic Grieve which will allow parliament a veto on the final Brexit deal. The Government lost the vote by 309 votes to 305 after Grieve, an ex-Attorney General, convinced 10 other Conservative MPs – and almost every opposition MP – to vote to ensure parliamentary oversight on the agreement the UK Government reaches with the 27 remaining EU states.
The first major Government defeat on the Bill underlines the difficulty facing the Prime Minister in governing a party split by opposing views on Brexit. It also represents an untimely setback following the deal the Government secured last week with the EU – and confirmed formally today – to finally move negotiations onto trade and Britain’s future relationship with the EU. In a sign of how seriously the Government took the vote, Julian Smith MP, the new Conservative Chief Whip, is alleged to have threatened legal action against MPs from his party who criticised the pressuring tactics used by the Government. Pro-EU Conservative MP Anna Soubry claimed that one MP had been reduced to tears by the whips’ tactics.
However, the 27 EU leaders have now agreed to move Brexit talks onto the second phase. The transitional period following the UK’s exit will be the first issue to be discussed, following by talks on trade and security cooperation from March. Theresa May described it as an “important step”, although Germany’s Angels Merkel said that the process was likely to get “even tougher” from now on. The follows agreement from the EU Parliament earlier in the week that talks should proceed to the next stage.
The Government will face further challenges with next week’s vote on an amendment to set the UK’s departure date from the EU for 29th March 2019. Pro-EU MPs argue that the specific date will make it more difficult to extend negotiations, whilst MPs favouring a hard Brexit argue that a set date will ensure that the UK does leave the EU even in the absence of a trade deal. In a further demonstration of splintering in the Conservative party, Stephen Hammond MP who was one of 11 Conservative rebels on the vote was within an hour removed as vice-chairman of the Conservative Party.