Failing to capitalise: Capital spending in the NHS

Failing to capitalise: Capital spending in the NHS The capital budget of the Department of Health and Social Care is used to finance long-term investments in the NHS in England. This includes spending on new buildings, equipment and IT, improvements to and some maintenance of NHS trusts, and research and development.

In this briefing, we analyse trends in the capital budget, comparing the UK with international averages. Using annual data from all NHS trusts in England, we then focus on trends in the capital spending of NHS trusts to analyse where money has been spent and where there are areas of need.

We also analyse the implications of recent capital spending, with a specific focus on NHS trusts’ maintenance backlog, and conclude with a discussion of the trends in capital spending and capital levels, and implications and recommendations for future health care. The Health Foundation

Mental health services: Addressing the care deficit

Mental health services: Addressing the care deficit A new report by NHS Providers reveals deep disquiet among NHS mental health trust leaders about a substantial care deficit resulting from the impact of growing social and economic hardship in their communities.
Mental health services: Addressing the care deficit looks at the levels of demand reported by frontline leaders across the range of services they provide, and examines what lies behind the growing pressures.

In particular the report identifies widespread concerns about benefits cuts and the impact of universal credit. It also suggests that loneliness, homelessness and financial hardship are adding to pressures on NHS mental health services.

See also:

• NHS bosses: Benefit stress driving mental health care demand The Guardian

Public must see benefits from changes to NHS commissioning

Public must see benefits from changes to NHS commissioning The NHS Long Term Plan is the latest change in three decades of changes to the structure of NHS commissioning organisations. The Long Term Plan sets out the intention for Integrated Care Systems to cover the whole of England by 2021. This will result in a significant reduction in the number of Clinical Commissioning Groups (CCGs).

The changes in organisational structures since 2012 have been particularly confusing and rapid. The changes make it challenging for taxpayers to understand who in their local area is accountable for health spending and performance.

It is important not to lose sight of the need for robust accountability structures which make it clear who is ultimately responsible for planning and commissioning decisions and to make this transparent to the public. The alphabet soup of health bodies that has grown up has done so, in many instances, without clear governance and accountability.

Many CCGs are currently underperforming and this will need to improve as they take on the responsibility for commissioning services across larger populations. Public Accounts Select Committee

See also:

• MPs say CCG performance will have to improve OnMedica

Improving patient safety through collaboration: a rapid review of the academic health science networks’ patient safety collaboratives

Improving patient safety through collaboration: a rapid review of the academic health science networks’ patient safety collaboratives This report discusses the progress and impact made by England’s Patient Safety Collaboratives (PSCs) in their first four years. It was commissioned by The AHSN Network and written by The King's Fund. The report notes how interest is shifting from supporting the improvement of individual services to improving how different services work together in local systems. It highlights the role the PSC programme has had in creating a movement for change and cultivating a shared vision among health and care organisations. It also suggests some areas PSCs and national NHS bodies could focus on to further support innovation, quality improvement and patient safety. AHSN Network

See also:

• Quality improvement for patient safety: a chance to steady the ship? The King's Fund

We need a big conversation about (women as) carers

We need a big conversation about (women as) carers Ten days ago my Twitter timeline was humming with comments, mostly highly critical, about an article by Giles Fraser for the website Unherd. The article was entitled 'Why won't Remainers talk about family?' I don't know if you saw it but in it he set out the argument that the free movement at the heart of the European Union has unhelpfully disrupted our communities and the caring, reciprocal relationships within them.

What really got a lot of people angry was nothing to do with Brexit but a section that seemed to assume it is a woman’s job to look after her ageing parents if and when they need care. Age UK

See also:

• Women ‘paying highest price’ for Tory’s failure to deliver social care reform, charities say The Independent

Cochlear implants to benefit more people with hearing loss

Cochlear implants to benefit more people with hearing loss Hundreds more children and adults with severe to profound hearing loss will be given the option of having cochlear implants, under new guidance.

It comes as the NHS watchdog NICE revised its definition of severe deafness - extending the number of people who could benefit.

Charities welcomed the move, suggesting previous guidance had been among "the strictest in the developed world".

The guidance applies to England and Wales. BBC News

More than 700,000 more adults could be put on blood pressure pills under new guidelines

More than 700,000 more adults could be put on blood pressure pills under new guidelines Hundreds of thousands more people should be offered drugs that lower blood pressure, according to new guidelines for doctors from the NHS medicines watchdog intended to tackle heart attack and stroke deaths.

As many as 720,000 extra adults could be prescribed drugs such as valsartan and beta blockers under the revised prescribing guidelines proposed by the National Institute for Health and Care Excellence (Nice). The Independent

See also:

• Hypertension in adults: diagnosis and management (consultation) NICE
• New NICE guideline on hypertension needs careful consideration, says College Royal College of General Practitioners
• High blood pressure drugs to be offered to thousands more BBC News

High price of cystic fibrosis drug not political, firm's boss tells MPs

High price of cystic fibrosis drug not political, firm's boss tells MPs CEO of company that makes Orkambi denies being ‘political minion’ for Donald Trump

The chief executive of a US company holding out for a high price from the NHS for its cystic fibrosis drugs was asked whether he might be considered “a political minion for President Trump” as he gave evidence to MPs on Thursday. The Guardian

See also:

• Sick children being denied drugs are a grim foretaste of a post-Brexit NHS | Polly Toynbee The Guardian
• Directors of cystic fibrosis drug firm in NHS standoff made £15m The Guardian

One in three hospital patients admitted as an emergency to be sent home without an overnight stay

One in three hospital patients admitted as an emergency to be sent home without an overnight stay Hospitals will be told to send far more emergency patients home on the same day, under new NHS plans.

Health officials say one in three emergency admissions will be sent home without an overnight stay, after being given access to on-the-spot tests.

They say patients with conditions as severe as pneumonia could be helped by new services, which will see them assessed, diagnosed, treated and sent home without an overnight stay. The Daily Telegraph

NHS transgender clinic accused of covering up negative impacts of puberty blockers on children by Oxford professor

NHS transgender clinic accused of covering up negative impacts of puberty blockers on children by Oxford professor An Oxford University professor has accused the NHS’s only specialised clinic for transgender children of suppressing negative results while undertaking experimental treatment on adolescents.

Dr Michael Biggs, an associate professor at Oxford’s Department of Sociology claims the Gender Identity Development Service (GIDS) has been giving puberty blocking hormones to children, without robust evidence as to the long-term effects. The Daily Telegraph