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
Tuesday, 27 September 2016
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
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
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.
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
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
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
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
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.
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.
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