Friday 30 September 2016

New signs make it easier for KGH patients

New signs make it easier for KGH patients Kettering General Hospital is replacing all of its internal directional signs to make it easier for patients and visitors to find their way around. Northamptonshire Telegraph

Increase in the number of people dying with dementia

Increase in the number of people dying with dementia A new range of products which examine the deaths of people recorded with dementia between 2012 and 2014 has been launched.

Figures show the number of deaths with a mention of dementia was:

  • 6.6% of all deaths in 2001
  • 15.8% of deaths in 2014
This is most likely due to an increase in awareness and recording of dementia.

The new reports were produced by the Dementia Intelligence Network (DIN) in collaboration with the National End of Life Care Intelligence Network (NEoLCIN) and draw on national data to see if there have been changes in dementia deaths over time, who the people dying with dementia are, where they die and the cause of their death.

The findings suggest that people who live in more deprived areas die with dementia at a younger age than those who live in more affluent areas.

There are also considerable differences between the place of death for people who have dementia and the general population. People with dementia are considerably more likely to die in hospitals and care homes and less likely to die at home or in end of life care settings such as hospices. Public Health England

Creating supportive environments: tackling behaviours that undermine a culture of safety

Creating supportive environments: tackling behaviours that undermine a culture of safety This report explores bullying and undermining within the medical workforce in the UK. It looks at current efforts to tackle problems and what further work is required. Academy of Medical Royal Colleges

"Brexit means Brexit" but how will it impact the NHS?

"Brexit means Brexit" but how will it impact the NHS? This infographic from the NHS European Office explains some of the possible implications of Brexit on the NHS. It looks briefly at six possible areas of impact, including finance, workforce and research, and asks what should be the NHS' main priorities as the UK prepares to leave the European Union. NHS European Office

The new test

The new test Campaigners are concerned that a highly accurate test that can identify babies with Down's syndrome during pregnancy will lead to more terminations. BBC News

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One in six young people 'eat fast food twice a day'

One in six young people 'eat fast food twice a day' One in six young people eat fast food twice a day, according to a survey of the nation's eating habits. BBC News

Carers' A&E visits can be preventable, says report

Carers' A&E visits can be preventable, says report One in 10 unpaid carers who called 999 or took their loved one to A&E did so because they did not know where else to go, a report by Carers UK suggests. BBC News

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Young women 'high mental health risk'

Young women 'high mental health risk' Young women have emerged as a high risk group for mental health problems, according to new data released by NHS Digital. BBC News

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The NHS: How bad will it get?

The NHS: How bad will it get? Look at almost any measure of performance, and the NHS in England is getting worse.

Waiting times for cancer care, accident and emergency units, ambulances and routine operations are all rising, and targets are being missed left, right and centre.

But just how bad is it? And how much worse will it get? Answering the first is relatively easy, the second not. BBC News

My clients assumed I had a new job – I couldn't say I had cancer

My clients assumed I had a new job – I couldn't say I had cancer As a therapist, personal boundaries are essential but when my own counsellor died of the disease I wished I’d been more open

Some years ago I found a lump in my right breast. In the week between tests and diagnosis I prepared a contingency plan, not for me but for my clients. My intuition told me this was cancer and, if so, I would need to stop working with immediate effect.

The day after the diagnosis I agreed with my then employer a hand-over plan, and what I would tell clients. Therapists are encouraged not to disclose information about themselves to clients. Personal boundaries are essential to avoid anything that might distort and take away from the story of the other, who is seeking support. Continue reading... The Guardian

Charity warns cervical cancer patients 'not getting the care and support they need'

Charity warns cervical cancer patients 'not getting the care and support they need' EXCLUSIVE: Almost a third of cervical cancer patients feel there is a lack of help available. Kate Bolton, 44, from London, reveals how she was left in the dark about the side effects of treatment. The Daily Mail

Anti-GP 'banter' hindering recruitment into general practice, top doctor warns

Anti-GP 'banter' hindering recruitment into general practice, top doctor warns Medical students are being put off becoming GPs by a culture of “banter” that stigmatises general practice as “soft” and “unglamorous”, the head of the profession has warned.

Maureen Baker, Chair of the Royal College of GPs, said the “systematic denigration” of family doctors was having a noticeable impact on the number medics choosing to pursue the vocation as a career.

The situation is being compounded, she said, by specialist hospital doctors, responsible for mentoring trainee medics, who too often “bad mouth” general practice. The Daily Telegraph

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Thursday 29 September 2016

East Northants and Corby people among the unhappiest in UK, according to study

East Northants and Corby people among the unhappiest in UK, according to study People in East Northamptonshire and Corby are among the unhappiest in the UK, according to data released by the Office for National Statistics. Northampton Chronicle and Echo

Policies could be costing lives claims former Northampton MP - as air pollution around North Gate bus station breaks legal limit

Policies could be costing lives claims former Northampton MP - as air pollution around North Gate bus station breaks legal limit A controversial series of policies could be seriously damaging the health of people in Northampton, a former MP claims after pollution figures revealed the area around the town’s bus station to be 25 per cent higher than legal limits. Northampton Chronicle and Echo

What if people had to pay £10 to see a GP?

What if people had to pay £10 to see a GP? The NHS if is a collection of essays that explores hypothetical scenarios and their impact on the future of health and care. Our aim is to encourage new thinking and debate about possible future scenarios that could fundamentally change health and care. This essay, by Professor John Appleby, explores the idea and implications of charging for GP appointments as a way of raising money to fund the NHS. The King's Fund

Plan to reduce health and care red tape burden

Plan to reduce health and care red tape burden Minister for Health Lord Prior is setting up the Burden Reduction Challenge Panel in partnership with NHS Providers, NHS Confederation and Care England.

The panel will look at evidence of both the burdens and benefits of current NHS and social care regulatory activity and will then challenge their use and necessity. Regulatory activity judged to be unnecessary by the panel and relevant officials will be amended or removed.

The organisations will engage health professionals to provide evidence that will feed into the panel. The panel’s first session will focus on data and information requests, at both national and local level. Department of Health

Making difficult decisions: commissioning healthcare in changing times

Making difficult decisions: commissioning healthcare in changing times This report aims to support CCGs in making difficult decisions about prioritisation of resources and changes to local services. It sets out factors that can enable CCGs to successfully command the confidence of the public, patients, local politicians and other key stakeholders when making changes. It draws on both academic research and practical insight from commissioners, patient groups and NHS England. NHS Clinical Comissioners

Improving efficiency and resource allocation in future cancer care

Improving efficiency and resource allocation in future cancer care This report, written in partnership with the Institute for Health Economics in Sweden, evaluates the current burden of cancer and identifies opportunities for increased efficiency in cancer care. The evidence focuses specifically on the health and cancer care landscape in nine European countries, including the UK. The report found that significant opportunity for improved efficiency exists in prevention activities and early diagnosis, for example targeting unhealthy behaviours such as high alcohol consumption and smoking, and the implementation of quality screening programmes. The report also highlights the potential to achieve greater efficiencies in the way new treatments are evaluated and how to enhance their uptake. Office of Health Economics

NHS negligence claims hit £1.4bn

NHS negligence claims hit £1.4bn NHS trusts in England paid out more than £1.4bn in medical negligence claims last year compared to £583m in 2008, analysis shows.

The NHS Litigation Authority (NHSLA), which handles claims on behalf of trusts, said it was trying to reduce the costs.

It blamed big rises in claims and legal costs from claimants.

Lawyers said the costs would not exist if the NHS had not been negligent and accused it of delaying claims. BBC News

Nursing homes 'closing each week'

Nursing homes 'closing each week' Nursing homes are closing at the rate of at least one per week in England, due mainly to a shortage of nurses, official figures suggest.

It means the number of nursing homes and nursing beds has fallen for the first time in five years.

A total of 73 homes cancelled their registration in the first six months of 2016, the Care Quality Commission said, partly due to recruiting problems. BBC News

'Shameful' pace of STP rollout risks financial meltdown, warns former NHS commissioning chief

'Shameful' pace of STP rollout risks financial meltdown, warns former NHS commissioning chief The timescale imposed by NHS England for developing sustainability and transformation plans (STPs) has been condemned as 'ridiculous' and 'shameful' by the former head of its commissioning policy unit. GP Online

Fifth of emergency bowel cancer cases had red flag symptoms

Fifth of emergency bowel cancer cases had red flag symptoms GPs are doing a good overall job of appropriately referring people suspected of having cancer but they need better access to tools to support timely diagnosis, warned GP leaders as UK research revealed that about a fifth of bowel cancer patients diagnosed as emergencies had had ‘red flag’ symptoms.

The study, published in the British Journal of Cancer and funded by Cancer Research UK, found that – as might be expected – ‘red flag’ symptoms were much more common in patients who were diagnosed via non-emergency routes, and that patients diagnosed as an emergency often did not display these symptoms strongly associated with bowel cancer. OnMedica

BMA calls on health secretary to join public debate on healthcare delivery

BMA calls on health secretary to join public debate on healthcare delivery The BMA has invited the health secretary Jeremy Hunt to take part in a public debate on the quality and consistency of healthcare delivery across the week.

Healthcare leaders, practitioners, and representatives from patient organisations and professional bodies are all expected to attend the symposium, which the BMA is hoping to stage before the end of this year, ideally in November. OnMedica

Junior doctors fail in high court challenge of new contract's legality

Junior doctors fail in high court challenge of new contract's legality Judgement rejects argument that Jeremy Hunt, the health secretary, exceeded powers over controversial contract

Junior doctors have lost a judicial review challenging the legality of a controversial new contract, which is now set to be introduced by Jeremy Hunt next week.

In a judgement published on Wednesday, Mr Justice Green rejected arguments presented at the high court by five junior doctors that the health secretary had exceeded his powers. Continue reading... The Guardian

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Half of weekend 111 calls abandoned at scandal-hit ambulance trust 

Half of weekend 111 calls abandoned at scandal-hit ambulance trust Nearly half of 111 calls have been abandoned at weekends at a scandal-hit ambulance trust which is to be put into special measures.

NHS watchdogs found patients across Sussex, Kent, Surrey and north-east Hampshire were put “at risk of harm” because there were not enough staff to respond to their calls, resulting in long delays and patients simply giving up on the service.

The investigation highlights a litany of failings at South East Coast Ambulance Service trust (Secamb), which has been rated inadequate. The Daily Telegraph

Wednesday 28 September 2016

Extra £25m for NHS organisations in England to improve mental health services for children and young people

Extra £25m for NHS organisations in England to improve mental health services for children and young people An extra £25m has been allocated to Clinical Commissioning Groups (CCGs) across the country to accelerate plans for improving mental health services for children and young people, helping to cut waiting times for treatment, reduce waiting list backlogs and minimise the length of stay for those in inpatient care. NHS England

Political maladministration to blame for unsafe hospital discharges, says Committee

Political maladministration to blame for unsafe hospital discharges, says Committee The incidence of unsafe discharge from NHS hospitals is unacceptably high as a result of political maladministration, says the Public Administration and Constitutional Affairs Committee report.

The PACAC inquiry found that the discharge failures identified by the PHSO report are not isolated incidents but rather examples of problems that patients, relatives and carers are experiencing more widely. Despite increased attention to the issue, it remains a persistent problem. There is a need for more data to be gathered on the scale and impact of these discharge failures.

Whilst excellent guidance on best discharge practice is available, the extent to which good practice is implemented varies across the country. Barriers to the implementation of best practice are prevalent both within hospitals and at the interface between health and social care. Pressures on resources and capacity within hospitals are leading to worrying and unsafe discharge practices. The Committee calls upon health and social care leaders to endure that staff are operating in a culture where person-centred care is the undisputed priority.

See also:

Growing older in the UK

Growing older in the UK This report argues that the UK's ageing population and its families are being failed by a fragmented health and social support system. It highlights how the health and life changes of older people are being negatively affected by the holes in the safety net of health, social and other welfare services. British Medical Association

Still not ready for ageing

Still not ready for ageing This paper assesses the government's response to the UK's ageing society and argues that action on tackling the challenges and maximising the opportunities of ageing has stalled. The Alliance calls for an urgent focus on social care in particular with the aim of achieving a sustainable long-term financial settlement. Ready for Ageing Alliance

Junior doctors await court decision over contract

Junior doctors await court decision over contract Junior doctors are waiting to hear whether England's High Court will agree to stop the government imposing a new contract.

The group Justice for Health says it mounted the legal challenge because the contract is "unsafe and unsustainable".

The Department of Health says the case is without merit. BBC News

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Hunt for three million 'ghost' patients

Hunt for three million 'ghost' patients As many as three million "ghost" patients registered with GP practices in England should be removed from doctors' lists, latest figures suggest. BBC News

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GP recruitment 'woefully inadequate', warns BMA

GP recruitment 'woefully inadequate', warns BMA The government is 'simply not on course' to meet its target of recruiting an extra 5,000 GPs by 2020, the BMA has warned after official data showed a slow rise in GP numbers over the past six months. GP Online

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Workforce data reveal 40% difference in GPs per patient between English regions

Workforce data reveal 40% difference in GPs per patient between English regions Across England as a whole there are 1,364 patients per GP, according to experimental statistics published by NHS DIgital.

But variation between regions is marked. In North Central and East London (NCEL) - which has the most GPs per patient - each primary care doctor looks after 1,122 patients on average, while in the East Midlands there are 1,572 patients per GP - 40% more than the NCEL total. GP Online

ME sufferers highlight lack of support and funding

ME sufferers highlight lack of support and funding People in 24 cities around the world, including six in the UK, are today protesting at the lack of support for people with myalgic encephalomyelitis (ME – ‘chronic fatigue syndrome’) in their school, work, family and social lives. They are demanding increased funding for both research into ME, and for better medical education about the disease, as well as trying to raise general awareness. OnMedica

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What would happen if gonorrhea became an untreatable 'super STI'?

What would happen if gonorrhea became an untreatable 'super STI'?If the most commonly used antibiotics could no longer treat gonorrhoea it could cause a spike in hospitalisation, infertility, HIV, and sepsis in the worst case scenario, a sexual health expert has told The Independent.

The World Health Organisation has recently warned that gonorrhoea, also known as "the clap", has developed widespread, high levels of resistance, and may become untreatable with an entire class of antibiotics.

Linda turned up at A&E twice a day. A dedicated team now stops that

Linda turned up at A&E twice a day. A dedicated team now stops that In Sunderland, where 6% of the population accounts for half the health spend, a new partnership is cutting hospital admissions

In a desperate effort to get relief for excruciating pain caused by osteoarthritis, curvature of the spine, and abdominal discomfort following surgery, Linda Douglas went to A&E twice a day.

The chronically ill 48-year-old, who lives near Sunderland, was “at the end of [her] rope” because of the constant pain and frequent hospital visits, and felt life “was not worth living”. That was until a new team of health and social care professionals took over her case and improved her quality of life from “six to 99%” in early 2016. Continue reading... The Guardian

Concern over bowel cancer patients with symptoms year before diagnosis

Concern over bowel cancer patients with symptoms year before diagnosis Researchers found a fifth of those who received an emergency diagnosis had symptoms that might have seen disease caught earlier

A fifth of bowel cancer patients who received an emergency diagnosis in one year in England had characteristic symptoms the year before, suggesting their disease could have been caught earlier, researchers say.

With the majority of patients having seen a doctor in the 12 months before their diagnosis, whether emergency or non-emergency, the authors of the new study say multiple factors could be behind the finding. Continue reading... The Guardian

The NHS needs 20 MORE hospitals: Experts warn 'tsunami' of patients means A&Es can't cope

The NHS needs 20 MORE hospitals: Experts warn 'tsunami' of patients means A&Es can't cope The Royal College of Emergency Medicine said the rising demographic caused by the growing levels of elderly, immigration and high birth rates are heaping pressure on A&Es. The Daily Mail

Carers in the 'sandwich generation' forced to act as nurses

Carers in the 'sandwich generation' forced to act as nurses More than 40,000 people caring for a cancer sufferer are now having to fulfil core nursing tasks such as administering medicine and changing dressings, new data reveals.

The cohort of people performing these roles has expanded by over quarter in the last five years, according to Macmillan Cancer Support.

They charity estimates they now form part of a 110,000-strong “sandwich generation” of carers who are faced with looking after both a parent with cancer and their own children, almost nine in ten of whom are also juggling a job. The Daily Telegraph

Tuesday 27 September 2016

King’s Fund reviews plans for digital NHS

King’s Fund reviews plans for digital NHS

In recent years, the digital agenda in health care has been the subject of an array of promises and plans, ranging from the secretary of state’s challenge to the NHS to “go paperless” to the commitment set out in the NHS’s Five Year Forward View to “harness the information revolution”.
NHS Networks

Three new units for mothers with mental ill health

Three new units for mothers with mental ill health

NHS England is preparing to invest in three new inpatient units for mothers with serious mental ill health to help them to stay with their babies.
NHS Networks

Guidance: Care Act Statutory guidance

Guidance: Care Act Statutory guidance

The edition published on 10 March 2016 supersedes the version issued in October 2014. It takes account of regulatory changes, feedback from stakeholders and the care sector, and developments following the postponement of social care funding reforms to 2020.
Department of Health

News story: Launch of the Children’s Oral Health Improvement Programme Board

News story: Launch of the Children’s Oral Health Improvement Programme Board


Today (26 September 2016) marks the official launch of the Children’s Oral Health Improvement Programme Board (COHIPB).

Chaired and led by Dr Jenny Godson who leads on oral health improvement at Public Health England (PHE), the COHIPB brings together stakeholder organisations that all have key leadership roles for children and young people, including NHS England, the LGA, the British Dental Association, and the Institute of Health Visiting.

The Board’s ambition is that “every child grows up free from tooth decay as part of every child having the best start in life”. The group’s oral health action plan and 5 high level objectives have been developed and agreed by partners working together following a PHE Best Start in Life oral health roundtable held in July 2015.

The Board’s objectives are to ensure:
child oral health is on everyone’s agenda
the early years and dental workforce have access to evidence based oral health improvement training
oral health data and information is used to the best effect by all key stakeholders
all stakeholders use the best evidence for oral health improvement
child oral health improvement information is communicated effectively

Although oral health is improving in England, almost a quarter (24.7%) of 5 year olds have tooth decay, and oral health accounts for a huge cost to health services. The NHS in England spends £3.4 billion per year on primary and secondary dental care (2014) (with an estimated additional £2.3 billion on private dental care). Tooth decay was the most common reason for hospital admission in children aged 5 to 9 in 2014/15 with over 26,000 children admissions for an almost entirely preventable disease.
Public Health England

Multimorbidity: clinical assessment and management

Multimorbidity: clinical assessment and management

This clinical guideline calls for a tailored approach to planning care when treating someone who has two or more long-term health conditions. It sets out ways to put patients with complex health issues at the heart of decisions about their care, including how to decide between different medicines and treatments. A database which summarises the benefits and adverse side effects of a number of common treatments has been created alongside the new guideline. It will help healthcare professionals work together with their patients to make joint decisions about their care.
National Institute for Health and Clinical Excellence (NICE)
Guideline
Database
Press release

Rising cost of drugs for diabetes approaches £1 billion per year

Rising cost of drugs for diabetes approaches £1 billion per year

The net ingredient cost (NIC)(2) of drugs for diabetes has increased by £88.0 million in 2015/16, bringing the annual primary care prescribing spend on this drug classification to £956.7 million - around £2.6 million per day, figures published today show.
ICQOF

First ever annual statistical publication for FGM shows 5,700 newly recorded cases during 2015-16

First ever annual statistical publication for FGM shows 5,700 newly recorded cases during 2015-16

21 July 2016: There were 5,700 (2) newly recorded (3) cases of Female Genital Mutilation (FGM) reported in England during 2015-16, according to the first ever publication of annual statistics.
ICQOF

Rest: Are we getting enough of it in our lives?

Rest: Are we getting enough of it in our lives?

The results of the world's largest ever survey on rest show that two-thirds of us would like more of it.
BBC News

NHS planning guidance 2017-19: steps in the right direction?

NHS planning guidance 2017-19: steps in the right direction?


Once upon a time we looked to election manifestos, White Papers and the Queen’s Speech to set out the path for NHS reform. These days it is statements from NHS England and NHS Improvement we must look to, and perhaps front of the queue comes the annual excitement ofNHS planning guidance. Last year’s guidance gave us sustainability and transformation plans(STPs) among other things, and this year’s has followed in its footsteps by giving us another round of changes.

Many of these changes are welcome. First, though the NHS has reverted back somewhat to organisational plans rather than the whole health economy – or place-based approach – aimed at by STPs, the guidance does make clear that these plans should nonetheless be consistent with STP plans. While this will no doubt raise lots of operational complexities, it does look to embed the cross-system working STPs were supposed to help enable.

Second, the guidance seems to reflect a greater degree of common oversight from NHS England and NHS Improvement (perhaps with their own national STP?) – trying to ensure the two organisations speak together with one voice. This is consistent with NHS Improvement’s single oversight framework which also looks to align the national bodies more closely amongst other things.

Third, the STPs themselves are evolving. This includes introducing STP-level control totals for finance, opening the door for local areas to re-balance the financial targets across their constituent members. There are also signs that the centre will accept some re-drawing of STP boundaries, at least over money. While again there will no doubt be major operational and governance issues in making use of these freedoms, evolution is likely to be better than another revolution as the NHS increasing (but not instantly) moves towards place-based systems of care. However, while the guidance is clear that ’what makes most sense for patients, communities and the taxpayer should always trump the narrower interests of individual organisations’, it sits increasingly awkwardly with a world of supposedly independent NHS organisations and their boards; not to mention an oversight system still reliant on the accountability of individual commissioners to NHS England, and individual providers to NHS Improvement. With STPs apparently here to stay, sooner or later the increasingly uneasy tension between the rapidly evolving place-based system and the organisation-based statutory framework will have to be addressed.

Fourth, the national bodies are trying to break out of the annual planning treadmill and have issued a two-year planning round backed by two-year contracts, a two-year tariff, Commissioning for Quality and Innovation (CQUIN) and Clinical Commissioning Group (CCG) quality premiums. Particularly when trying to bring about transformational change, providing greater certainty is essential and something many have been asking for. This is all the more impressive given that the occasional reference to the Department of Health and HM Treasury suggests there must have been a lot of behind-the-scenes negotiation to get this out.

Finally, for as long as I can remember the regular launch of the guidance in the run-up to Christmas (22 December last year, with some major building blocks coming out even later than this) has widely been recognised as too late. So bringing the launch forward by three months to 22 September has bought everyone valuable extra time.

So are there any downsides? Well, getting out the guidance early was arguably necessary for the NHS to have any chance of planning its way out of the current financial and operational malaise. However, it is certainly not sufficient. What is asked of the NHS remains breathtaking: to maintain (or recover) performance, to manage its finances, and to push forward on transformation. And all of this without any real growth in its budget (as 2016/17 was the good year for growth), and with demand continuing to rise relentlessly.

The guidance also carried on some arguably less than helpful behaviours; most obviously it is a very long document indeed once the annexes are included – only serving to increase the demand on those tasked with seeing it through. More significantly, it also maintains and reinforces the central grip that has become so noticeable. So the Sustainability and Transformation Fund is here to stay, and remains primarily tasked with deficit support rather than transformation – given out retrospectively only if trusts meet their finance and performance targets. The centre also remains very keen on plans, detailed monthly trajectories, controls and sanctions, and will be issuing a new set of metrics to cover STP performance as well. On top of this, various pots of money are held back or ring-fenced to encourage local areas to do as they are instructed; whether on mental health, general practice, diabetes or delivery of the digital agenda.

The reliance on central control is noticeable in other areas too. Though the nine national ‘must-dos’ have been carried forward in name from last year, the detail underpinning them has in some cases become longer and potentially more difficult to tackle. So while many might argue that elements of the mental health, general practice, cancer and maternity strategies were right to add as ’must-dos’, in the current climate just adding these to a long list of other things the NHS must already do (which includes seven-day services, by the way) represents wishful thinking. Short of a miracle, the NHS cannot do everything.

However substantial NHS planning guidance has become these days, it is hardly the place to kick off the increasingly necessary debate about what the NHS can afford within its current financial settlement. But is it a debate that is becoming increasingly hard to avoid.

Monday 26 September 2016

New whistleblowing protection for doctors in training

New whistleblowing protection for doctors in training Health Education England has released details of the enhanced whistleblowing protection agreement for doctors in training. NHS Employers

Illnesses associated with lifestyle cost the NHS £11bn

Illnesses associated with lifestyle cost the NHS £11bn Health problems related to poor diet, drinking and smoking are costing the NHS in England more than £11bn each year, officials say.

Public Health England (PHE) says that unless they are tackled more effectively the NHS will become unaffordable.

It warns conditions such as diabetes and smoking-related bronchitis are a new and untreatable epidemic. BBC News

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Women's mental health needs 'not considered adequately'

Women's mental health needs 'not considered adequately' Women's mental health needs are "not being considered" despite rising rates of suicide, campaigners warn. BBC News

Junior doctors' strike action called off

Junior doctors' strike action called off Junior doctors in England suspend a series of five-day strikes over the next three months, the British Medical Association announces, following concerns over patient safety. BBC News

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Andrew Lansley fails to recognise that his NHS reforms just don't work

Andrew Lansley fails to recognise that his NHS reforms just don't work Each discrete part of the Health and Social Care Act may have had virtues, but it led to massive cost and disruption

One of Andrew Lansley’s failings as health secretary was his apparent belief that the only reason he was under attack from all sides for his NHS reforms was because people had not grasped what he was trying to do. The solution was not to listen to their concerns, but for him to explain it all one more time.

Four years later he is still explaining, and still not listening. Delivering the NHS Providers’ annual lecture this week Lansley failed to demonstrate any understanding that the Health and Social Care Act he drove through created huge disruption and enduring difficulties. Continue reading... The Guardian

I've worked as a GP receptionist under a year and I'm already burnt out

I've worked as a GP receptionist under a year and I'm already burnt out I came into the job to help patients but there are just so many. Neither I nor the NHS can keep this up

It’s only 8.15am and the appointments for the day are already fully booked despite our appointment booking line opening at 8am. Less than a year ago this was an anomaly, now it’s the norm, as are queues out the door when we open. I spend the rest of the morning bearing the brunt of patient irritation, which is mostly aimed at our lack of appointments. I share their frustration because the service is substandard and it only seems to be getting worse.

The calls keep flooding in, the phone rings all day and I often finish work with a headache from the sound. The calls can be incredibly stressful one moment – talking to someone who is struggling to breathe – to mundane the next with patients who are convinced that their three-day cough constitutes an emergency. Patient anger often unfortunately comes back on to the receptionists, I wish they could see the wider picture and direct their anger at the government that is responsible for cutting their services. Continue reading... The Guardian

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Hospitals and care homes fail food safety inspections

Hospitals and care homes fail food safety inspections Data shows more than 500 places caring for vulnerable people, including nurseries and playgroups, require improvement

More than 500 care providers in the UK, including 19 hospitals and other NHS facilities, have failed hygiene and food safety inspections, Guardian analysis reveals.

Food Standards Agency (FSA) data shows that care homes fail to meet food hygiene standards more than any other type of care provider, with more than 200 residential, nursing and care homes receiving low grades at their latest food safety inspections. Continue reading... The Guardian

Boris Johnson says NHS will get substantial extra funds after Brexit

Boris Johnson says NHS will get substantial extra funds after Brexit Foreign secretary tells Andrew Marr he agrees with former health secretary’s figure of at least £5bn being available by 2020

Boris Johnson has said the NHS will get substantial extra funding after Brexit, despite Theresa May’s refusal to endorse the leave campaign’s promise of an additional £100m a week.

The foreign secretary strayed from his brief during BBC1’s Andrew Marr show to sign up the prime minister to a cash injection for health services during this parliament. Continue reading... The Guardian

NHS is wasting millions on drugs for the male menopause claims new research

NHS is wasting millions on drugs for the male menopause claims new research Testosterone prescriptions have shot up 20 per cent since 2012 – costing the NHS £20 million a year. Researchers claim doctors are being increasingly influenced by drug companies. The Daily Mail

Revealed: 8,000 hospital consultants paid more than the Prime Minister

Revealed: 8,000 hospital consultants paid more than the Prime Minister Eight thousand hospital consultants earn more than the Prime Minister from the National Health Service, a health minister has admitted.

The figures are thought to be the first time that the Government has estimated how many consultants earn than the Prime Minister.

They are set to ignite a row about whether consultants should be allowed to continue lucrative private practices while taking home such large sums from the NHS. The Daily Telegraph

Just four in ten children have seen an NHS dentist in last years 

Just four in ten children have seen an NHS dentist in last years More than four in 10 children have not visited an NHS dentist in the last year, according to new figures which reveal stark differences across the country.

Experts said the official statistics were “alarming” with tooth decay now the most common reason for young children to be admitted to hospital.

The official statistics reveal for the first time the areas where children are most and least likely to be have seen an NHS dentist in the last year. The Daily Telegraph

See also:

Friday 23 September 2016

Personal well-being in the UK: 2015 to 2016

Personal well-being in the UK: 2015 to 2016 Since 2011, the Office for National Statistics has asked personal well-being questions to adults in the UK, to better understand how they feel about their lives. This report presents headline results from the fifth year of data collection, covering the financial year ending March 2016, together with how things have changed over the 5 years. It finds that:
  • there has been no improvement in ratings of happiness, anxiety and feeling that things in life are worthwhile over the 1 year period between the years ending March 2015 and 2016
  • reported personal well-being has improved across each of the measures over the 5 year period between the years ending March 2012 and 2016
  • those living in London reported lower average ratings of life satisfaction, anxiety and feeling things in life are worthwhile compared with UK overall
  • people in Northern Ireland continue to give higher average ratings of personal well-being for all measures except anxiety, when compared with the other UK countries
  • although women reported higher life satisfaction and worthwhile levels when compared with men, they also reported higher levels of anxiety
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Health care assistants being used as ‘nurses on the cheap’

Health care assistants being used as ‘nurses on the cheap’ Healthcare assistants (HCAs) working in the NHS are doing the jobs of nurses without the equivalent pay or education, says a new report.

Two in five (39%) say they have not received the training necessary to provide the care expected of them such as looking after dementia patients, according to the report­­ Care on the cheap.

Less than half (45%) of HCAs feel the tasks they are asked to do­ – including giving patients medication, doing heart checks and inserting medical tubes – are appropriate to their level of competence.

The findings are based on a survey of nearly 2,300 HCAs across the UK working in primary and secondary care including GP practices, emergency departments and in the community. UNISON

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NHS England and NHS Improvement set out next steps to implement the NHS Five Year Forward View in 2017/18 and 2018/19

NHS England and NHS Improvement set out next steps to implement the NHS Five Year Forward View in 2017/18 and 2018/19 National NHS leaders have set out steps to strengthen collaboration across the NHS and ensure that local health and care areas are successful in delivering their blueprints for the future.

Published by NHS England and NHS Improvement, Delivering the Forward View: NHS Operational Planning Guidance for 2017/18 and 2018/19 provides NHS trusts and commissioners with tools they need to plan for the years ahead.

For the first time, the guidance covers two financial years, to provide greater stability, underpinned by a two-year tariff for NHS patients and a two-year NHS Standard Contract.

A false economy: cuts to continuing professional development funding for nursing, midwifery and the allied health professions

A false economy: cuts to continuing professional development funding for nursing, midwifery and the allied health professions This report highlights the risk posed to the NHS by the funding cuts and calls for the Department of Health to lead a discussion to address the disconnect between the funding decisions and national strategic priorities. It also warns about the potential consequences of the cuts for the Government’s push to expand student numbers as part of plans to reduce staff shortages. Council of Deans Health

Agonising wait

Agonising wait A family whose daughter spent four years in a vegetative state say it should be easier to withdraw nutrition from such patients. BBC News

Childhood vaccinations 'down again'

Childhood vaccinations 'down again' The percentage of under-twos in England receiving most routine vaccinations is down slightly for the third year in a row, NHS figures show. BBC News

IVF rates in England 'at 20-year low'

IVF rates in England 'at 20-year low' Campaigners say the provision of free IVF on the NHS in England has fallen to its lowest level since guidelines were introduced in 2004.

Figures from the charity Fertility Fairness show a steady decline in the number of providers offering the recommended three cycles of treatment.

Fourteen local health groups are currently considering whether to reduce or remove IVF provision.

The NHS says it does not have "unlimited resources". BBC News

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UK fifth in world for health-related sustainable development goals

UK fifth in world for health-related sustainable development goals Although the UK is ranked fifth overall in the world in making progress towards the United Nations’ health-related sustainable development goals (SDG), it is doing relatively poorly on some of the indicators – notably those relating to HIV, smoking, alcohol, suicide, overweight and air pollution.

The UN General Assembly established the SDGs in September 2015, to replace the millennium development goal (MDG) framework that expired last year; the SDGs specify 17 universal goals, 169 targets, and 230 indicators leading up to 2030. The authors of the latest assessment of progress, published today in The Lancet, have compared 33 health-related SDG indicators across 188 countries. OnMedica

We can afford the NHS. The question is whether we are willing to pay for it

We can afford the NHS. The question is whether we are willing to pay for it Rationing funds between competing claims within the health service is nothing new. It doesn’t mean the nation can’t afford good healthcare through taxation

What can the NHS afford? Every week one pressure group after another protests at rationed treatments, as the NHS suffers its greatest funding shortfall since it was founded. Continue reading... The Guardian

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The REAL scale of cancelled operations: 40,000 scrapped procedures but were not included in the official figures

The REAL scale of cancelled operations: 40,000 scrapped procedures but were not included in the official figures Data was obtained from 156 NHS trusts in England. They provided figures for operations cancelled one to three days before a patient was due to be admitted. The Daily Mail

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NHS out-of-hours services being run without a single doctor with some turning to refugee medics to plug GP shortage

NHS out-of-hours services being run without a single doctor with some turning to refugee medics to plug GP shortage NHS out-of-hours services are being run without a single doctor in some parts of the country, as other practices turn to refugee medics to plug desperate shortages of GPs.

Experts said patients were being put at risk by a scarcity of family doctors, which could result in up to 600 practices closing their doors by 2020.

The growing crisis means parts of Yorkshire covering up to 300,000 patients have been left without any doctor to send out at night, an investigation found. The Daily Telegraph

Self-harm among armed forces jumps by a third in past five years, figures reveal

Self-harm among armed forces jumps by a third in past five years, figures reveal The number of armed forces personnel deliberately self-harming has jumped by more than a third over a five-year period.

Figures released by the Ministry of Defence revealed a 36 per cent increase in servicemen and women who self-harmed at least once between 2010/11 and 2014/15.

There were 383 recordings of deliberate self-harming (DSH) - including self-injury and self-poisoning - for Navy, Army and RAF personnel in 2014/15, up from 339 in 2010/11.

The data excludes servicemen and women who had thoughts of DSH or suicide.

Women, Army personnel and those aged under 24 were most at risk, the figures suggested. The Daily Telegraph

Thursday 22 September 2016

Clear and credible plan needed for digital health

Clear and credible plan needed for digital health Government ministers and NHS leaders should set out a definitive plan for expanding the use of digital technology in the health service, according to a new briefing.

The briefing highlights the risk of losing credibility and commitment among frontline NHS staff if the digital health agenda continues to be subject to shifting priorities, new initiatives and slipping timescales. It calls for urgent clarification of when funding already announced will be made available, warning that holding back investment until later in the parliament will inevitably slow down progress. The King's Fund

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Stoptober quit smoking campaign returns

Stoptober quit smoking campaign returns Smokers across the country are being urged to take part in Stoptober (the mass quitting challenge from Public Health England (PHE) starting on 1 October) and join nearly 15 million people who have already quit.

Last year, out of the 2.5 million smokers who made a quit attempt, 500,000 people (20%) were successful; the highest recorded success rate and up from just 13.6% 6 years ago. Public Health England

News story: UK secures historic UN Declaration on antimicrobial resistance

News story: UK secures historic UN Declaration on antimicrobial resistance The agreement follows a worldwide campaign led by the Chief Medical Officer Professor Dame Sally Davies and Health Secretary Jeremy Hunt to highlight the threat posed to modern medicine by antimicrobial resistance (AMR).

Every signatory has agreed that drug resistant infections must be tackled as a priority. The nations have committed to:

  • develop surveillance and regulatory systems on the use and sales of antimicrobial medicines for humans and animals
  • encourage innovative ways to develop new antibiotics, and improve rapid diagnostics
  • raise awareness among health professionals and the public on how to prevent drug resistant infections
Drug-resistant infections pose the biggest threat to modern medicine. Currently, it is estimated that more than 700,000 people die annually due to drug-resistant infections such as TB, HIV and malaria but, because of the lack of global data, it is thought that the real number is likely to be far more. Department of Health

Fiscal sustainability analytical paper: fiscal sustainability and public spending on health

Fiscal sustainability analytical paper: fiscal sustainability and public spending on health This paper reviews the latest evidence on the demographic and non-demographic determinants of health spending in the UK and its implications for the Office for Budget Responsbility's long-term health spending projection. It finds that demographic effects have explained only a small part of the increase in health spending over past decades and that they are likely to remain a relatively small, although growing, driver of spending in the future. Office for Budget Responsibility

Many cancelled operations 'unrecorded'

Many cancelled operations 'unrecorded' Tens of thousands of operations were cancelled by English hospitals last year but not officially counted, figures obtained by the BBC suggest.

About half of trusts provided details of cancellations one to three days before admission.

Hospitals must record cancellations on the day of an operation or of admission - but not those prior to that.

NHS England said official figures showed less than 1% of operations were cancelled at the last minute. BBC News

NHS should get £5bn 'Brexit bonus' - Lansley

NHS should get £5bn 'Brexit bonus' - Lansley The NHS should get a £5bn-a-year "Brexit bonus", former Conservative Health Secretary Andrew Lansley says. BBC News

Chris Brennan inquest: Hospital neglect 'contributed to teenager's death'

Chris Brennan inquest: Hospital neglect 'contributed to teenager's death' Neglect by one of England's largest mental health trusts contributed to the death of a boy, a coroner rules. BBC News

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Breast cancer patients denied ‘life-saving’ 43p treatment ‘due to NHS funding dispute’

Breast cancer patients denied ‘life-saving’ 43p treatment ‘due to NHS funding dispute’ Thousands of patients are being denied “life-saving” breast cancer drugs which cost just 43 pence due to an NHS funding row, research has suggested.

Charity Breast Cancer Now estimates 27,000 women in the UK are being denied osteoporosis medication which can prevent breast cancer spread in the bone due to on-going uncertainty as to who is responsible for funding the medication. The Independent

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One dying patient taught me that doing nothing can be brave

One dying patient taught me that doing nothing can be brave The patient who loved chicken wings showed me that healthcare professionals fail to hear what really matters in end-of-life care

“There is something actually, doctor.” I turned around in relief. Continue reading... The Guardian

NHS will remain free to use and funded by general taxation, government says

NHS will remain free to use and funded by general taxation, government says Reaffirmation comes in response to OBR projections laying out ever larger sums service will need in coming decades

The NHS will remain funded from general taxation and free for patients to use, the government has pledged, in a statement that appears to rule out the introduction of charges to access care.

The government was responding to new projections from the Office for Budget Responsibility showing that the health service would need such large sums of money in the coming decades that it would threaten the UK’s public finances. Continue reading... The Guardian

Half of skin cancer patients are failing to be referred urgently Nice warns 

Half of skin cancer patients are failing to be referred urgently Nice warns Health watchdogs have called for improvements in diagnosis and treatment of skin cancer after new figures showed just half of skin cancers are being diagnosed after an urgent referral by GPs.

The warning from the National Institute for Health and Care Excellence (Nice) comes as figures show cases of skin cancer have risen by almost 50 per cent in a decade.

In England there were 12,246 new cases of malignant melanoma in 2013, with around 2,000 deaths a yearThe Daily Telegraph

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Wednesday 21 September 2016

Underfunded, underdoctored, overstretched: The NHS in 2016

Underfunded, underdoctored, overstretched: The NHS in 2016 The NHS in 2016 is under-funded, under-doctored and overstretched. Patients and communities deserve to know the true choice that we face: increase funding or cut care. The RCP believes they deserve more than that: an NHS funded and staffed to meet their needs, now and in the future. The NHS in 2016 needs a new plan – a plan designed to meet the UK’s health and care needs in the long term, and to value, support and motivate NHS staff.

This report is the first of a series in our Mission: Health campaign which will be focused on three major themes – working for health, delivering health, and creating health. Royal College of Physicians

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Who knows best? Older people’s contribution to understanding and preventing avoidable hospital admissions

Who knows best? Older people’s contribution to understanding and preventing avoidable hospital admissions The authors of this report interviewed 104 older people, exploring their experiences of emergency admissions. The research focused on whether the older people felt it was appropriate to be admitted to hospital and whether they thought anything could have prevented their admission. The findings of this study confirm the belief that older people have an important role to play in helping understand the nature of emergency admissions and to devise appropriate responses to their rising numbers. The report concludes that ignoring this expertise could be detrimental to ensuring older people get the appropriate care they need. University of Birmingham

Face-down restraint continuing in NHS

Face-down restraint continuing in NHS Face-down physical restraint is still being used in mental health wards in England, despite the government and the NHS saying it should stop.

Its use, which can restrict a patient's breathing, dropped only slightly over the two years following new guidelines.

In 2013-14, 22.4% of recorded incidents of restraints were face-down, falling to 18.5% by 2015-16.

Some healthcare trainers say face-down restraint can be the only appropriate way of keeping staff and patients safe.

The total number of recorded restraints rose by 16.6% from 2013-14 to 2015-16, although NHS managers said better reporting might be part of the reason for the increase. BBC News

Global pledge to stamp out drug-resistant infections

Global pledge to stamp out drug-resistant infections The 193 countries of the United Nations sign a landmark declaration to rid the world of drug-resistant infections or superbugs. BBC News

First head transplant by 2017, claims surgeon

First head transplant by 2017, claims surgeon Professor Canavero says he's a year away from transplanting a head onto a totally different body and has lots of volunteers from the UK who want it done. BBC News

NHS budget pressures will leave mental health services underfunded, spending watchdog warns

NHS budget pressures will leave mental health services underfunded, spending watchdog warns The Government will struggle to properly improve mental health services with the NHS budget at current levels, an influential committee of MPs has found.

The Public Accounts Committee looked at how much funding the Government had provided to reach its goal of putting mental health on “parity of esteem” with physical health and found funding shortfalls would make the “laudable ambition” very difficult.

“We are sceptical about whether this is affordable, or achievable without compromising other services,” the report says. The Independent

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Debt, homelessness, domestic violence: the GP practice acting as a one-stop shop

Debt, homelessness, domestic violence: the GP practice acting as a one-stop shop In Oldham, specialist nurses work with GPs to help tackle poor health, social isolation and deprivation

Lisa Baxter*, a mother of three from Oldham, was trapped with a violent partner, difficulties controlling her children, threats of homelessness and frightening debt. Her only ways of coping with her desperation were by abusing drugs and alcohol, and frequent appointments with her GP for antidepressants – until she was referred to community nurse, Ruth Chorley.

I don’t know what I would have done without Ruth. Without her, I think I would have had my children taken off me Continue reading... The Guardian

Jeremy Hunt 'acted within his powers' over junior doctors' contracts, court told

Jeremy Hunt 'acted within his powers' over junior doctors' contracts, court told Lawyer for junior doctors’ campaign group says health secretary could only recommend a deal, not impose one

Jeremy Hunt did not go beyond the “scope of his powers” as health secretary when approving a new NHS contract opposed by junior doctors, a barrister has told the high court.

Clive Sheldon QC said Hunt had been “clear” about what his powers were. Continue reading... The Guardian

Jeremy Hunt pledges fair deal for elderly cataract patients

Jeremy Hunt pledges fair deal for elderly cataract patients EXCLUSIVE - A postcode lottery in England that deprives cataract sufferers of vital surgery is to end. The shake-up was not due before 2018 but Jeremy Hunt has brought it forward 12 months. The Daily Mail

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NHS ban on staff receiving gifts worth more than £50 in crackdown

NHS ban on staff receiving gifts worth more than £50 in crackdown NHS staff will be banned from accepting gifts over £50 and told to declare hospitality under the first national code on conflicts of interests.

Health officials said the new rules aimed to sweep away a “cloud” hanging over the health service in previous dealings with lobbyists.

Under the terms, all doctors and managers will be obliged to record any wining and dining worth more than £25, while gifts worth more than £50 will be banned.

Every NHS organisation will be ordered to run a register which lists potential conflicts of interest held by staff - such as hospitality received, involvement in sponsored events and private business interests. The Daily Telegraph

"Chemical cosh" of powerful drugs still routinely used to knock out dementia patients in care homes

"Chemical cosh" of powerful drugs still routinely used to knock out dementia patients in care homes Hundreds of care homes are still regularly using a “chemical cosh” of powerful drugs to quieten difficult dementia patients, despite a national review into the practice, a new report suggests.

A study from five universities found no overall reduction in the prescribing of antipsychotics in UK care homes between 2009 and 2012, three years after the Government launched the National Dementia Strategy.

In 2012, 77 per cent of treatments using the drugs were described as “excessive” and lasting for longer than the recommended six weeks, the report found. The Daily Telegraph

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Tuesday 20 September 2016

Housing and health: ships that pass in the night?

Housing and health: ships that pass in the night? We have known for many years that good-quality housing is critical to health. Research evidence tells us this, our common sense tells us this, the NHS and wider health and care sector knows this, and the housing sector knows this.

But, despite this knowledge, and many good intentions, the housing and health sectors are too often like ships that pass in the night. Why is that, and what needs to be done to change it? The King's Fund

Improving Health Care Through Better Conversation

Improving Health Care Through Better Conversation Research shows that people often don’t take their medications or change their lifestyles after after visiting a doctor or a nurse, while only about 60 per cent of people feel they are sufficiently involved in decisions about their care.

A campaign is being launched to tackle this issue and improve the way in which health professionals and people talk.

Better Conversations’ looks at how clinicians and commissioners can introduce health coaching and will provide information, evidence and tips on how to have a more equal conversation with people and are treated as partners in their care, rather than passive recipients. Coalition for Collaborative Care

Why is diagnosing frailty important?

Why is diagnosing frailty important? Professor Martin Vernon, National Clinical Director for Older People and Integrated Care at NHS England discusses the importance and potential in diagnosing frailty. NHS England

NHS watchdog issues sexting advice

NHS watchdog issues sexting advice Any child or teenager sending explicit images or messages on texts and emails is cause for concern and should be monitored, new guidelines for schools and health professionals in England advise. BBC News

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One hospital's fight with care shortfall

One hospital's fight with care shortfall (video) New figures show a rapid rise in the numbers of people unable to leave hospital, because of problems providing them with care at home.

It is costing the NHS £820m per year and putting hospitals under huge strain.

Alison Holt visited one hospital in Liverpool to see the impact of the shortfall on front line services. BBC News

Zika cases in UK travellers triple in a month as 100 new cases confirmed

Zika cases in UK travellers triple in a month as 100 new cases confirmed UK GPs encountered an unprecedented number of Zika virus cases over the past few weeks, data from Public Health England (PHE) suggest, as the number of confirmed cases in travellers tripled in the past month. GP Online

Progress made in cutting antimicrobial resistance

Progress made in cutting antimicrobial resistance Progress is being made in preventing antimicrobial resistance (AMR) in the UK, according to two new government reports.

The government has published its official response report to Lord O’Neill’s review Tackling drug-resistant infections globally, which made 10 recommendations on how to best prevent the challenge of antimicrobial resistance.

Lord O’Neill’s review’s recommendations included raising awareness of AMR globally, reducing the use of antibiotics in animals and improving hygiene to help stop the spread of infection.

It also highlighted the consequences of not taking steps to tackle AMR, warning that there could be 10 million deaths a year by 2050 and the potential end of modern medicine as we know it. OnMedica

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Number of smokers in England falls to record low

Number of smokers in England falls to record low Smoking rates across England are the lowest on record, health officials have said.

Public Health England (PHE) said that 16.9 per cent of the population in England are smokers - the lowest level since records began.

The figures were released as the health body launched its annual Stoptober campaign to encourage the nation's remaining smokers to quit for the month of October. If people give up the habit for 28 days they are five times more likely to quit for good, PHE said. The Independent

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NHS plans to make senior doctors reveal outside earnings

NHS plans to make senior doctors reveal outside earnings About half of hospital consultants are believed to undertake private work, risking conflicts of interests, says NHS England

Doctors will have to reveal the amount of money they earn from private work under new plans to improve transparency. NHS England chairman Sir Malcolm Grant told the Times that the extent of private work carried out had been “under the radar” for too long. “We are looking into something that is quite a touchy subject,” he said.

A spokesman for NHS England, which is trying to increase transparency, said that every hospital is to publish a register of consultants’ outside earnings from April in a drive to unearth potential conflicts of interest. It is believed that about half of England’s 46,000 NHS consultants do private work, on top of average earnings of £112,000 a year. Continue reading... The Guardian

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