GMC calls for tougher powers to check European doctors' skills

GMC calls for tougher powers to check European doctors' skills Regulator’s chief executive says EU rules still have major weaknesses and moves to introduce digital ‘passports to practise’ could make matters worse

EU rules governing the checks that UK authorities can make on doctors still have major weaknesses seven years after a patient safety scandal revealed catastrophic flaws in the system, according to Britain’s medical regulator.

Niall Dickson, chief executive of the General Medical Council (GMC), said it must have the same powers to check the competence and medical skills of doctors from Europe as it already does for medics from the rest of the world.

We are worried that something will go wrong if we are not able to do what we need to do. Continue reading... The Guardian

Andrew Lansley takes post advising drugs firm involved in dispute with NHS

Andrew Lansley takes post advising drugs firm involved in dispute with NHS Former health secretary declares three more private sector jobs roles on House of Lords register of interests.

Andrew Lansley, the former health secretary, has taken on three more private sector jobs, including advising a pharmaceuticals firm at the centre of a row over the price it charges the NHS for cancer drugs.

Despite David Cameron’s promise in 2010 to end the “revolving door” between Whitehall and the private sector, the recently ennobled Tory peer has declared work as an adviser to Roche, the Swiss drugs company, and as an adviser to private equity firm Blackstone on investments in the health sector. Continue reading... The Guardian

Telling people they are at risk of disease makes the healthy sick, warns professor

Telling people they are at risk of disease makes the healthy sick, warns professor Doctors are treating people at risk of disease as if they have already developed the condition, an expert warns. The Daily Telegraph

New laser treatment for prostate patients treated at Kettering General Hospital

New laser treatment for prostate patients treated at Kettering General Hospital Kettering General Hospital has introduced a new laser operation to help patients who need treatment for benign enlargement of the prostate. Northamptonshire Telegraph

ESPAUR report reveals continued rise in antibiotic resistant infections

ESPAUR report reveals continued rise in antibiotic resistant infections A new report from Public Health England shows that overall antibiotic resistant infections increased through 2014. Rates of bloodstream infections caused by Escherichia coli and Klebsiella pneumoniae increased by 15.6% and 20.8% respectively, from 2010 to 2014. However, Streptococcus pneumoniae bloodstream infections reduced by 23% between 2010 and 2014, which may be related to increased pneumococcal vaccination rates.

See also:

• English surveillance programme for antimicrobial utilisation and resistance (ESPAUR) report Public Health England
• Shared decision making reduces antibiotic use OnMedica
• Dr Maureen Baker: GPs have made real progress on antibiotic prescribing, but there's still more to do GP Online
• 'Last resort' antibiotics pose growing threat to healthcare, report warns The Guardian
• Hospitals turning to last-resort antibiotics as drug-resistant infections continue to rise The Independent

Guidance for people with dementia and carers

Guidance for people with dementia and carers Guidance for carers and people with dementia to explain what good quality services should look like. London Dementia Strategic Clinical Network

See also:

• Dementia – Immediate Post Diagnosis Support Guidance London Dementia Strategic Clinical Network

Smart dressing 'cuts antibiotic use'

Smart dressing 'cuts antibiotic use' A medical dressing that changes colour when it detects infection could cut the unnecessary use of antibiotics, say scientists at Bath University. BBC News

FPLD disappointed with government response to consultation on ‘No voice unheard, no right ignored’

FPLD disappointed with government response to consultation on ‘No voice unheard, no right ignored’ Earlier this week, the government responded to the consultation on No voice unheard, no right ignored, which was commissioned under the previous coalition government.


Addressing similar issues to the recently unveiled NHS England national plan Building the Right Support, the consultation sought to explore ways people with learning disabilities could be supported to lead more independent lives and to have more control and choices over the services they receive. However, the government’s consultation response has come as a disappointment to the Foundation for People with Learning Disabilities.

GP practices must deliver further efficiency savings, NHS England tells DDRB

GP practices must deliver further efficiency savings, NHS England tells DDRB NHS England has rejected BMA warnings that GP practices have delivered nearly all possible efficiency savings in evidence to the Doctors and Dentists Review Body (DDRB). GP Online

Hundreds of consultants tell Jeremy Hunt they back junior doctors' strike

Hundreds of consultants tell Jeremy Hunt they back junior doctors' strike Royal Free London consultants write to health secretary saying junior doctors are integral to NHS and they will support any industrial action.

Hundreds of consultants from the Royal Free London NHS foundation trust have written to the health secretary, Jeremy Hunt, to express their support for junior doctors and to back possible industrial action.

In a letter to the Guardian, the 505 consultants, who will bear the brunt of any potential strike, say they recognise that junior doctors are an integral part of the health service. Continue reading... The Guardian

See also:

• Junior doctors contract row: an explainer The Guardian
• NHS junior doctor contracts: UK's leading expert on patient safety Sir Robert Francis urges doctors not to strike The Independent
• Junior doctors strike: 40,000 prepare to stage mass walk-out in December The Independent

Surge in number of UK adults with diabetes

Surge in number of UK adults with diabetes On World Diabetes Day, British Heart Foundation analysis finds nearly 3.5 million British people have condition.

The number of UK adults with diabetes has risen by more than 65% since 2005, figures show. Continue reading... The Guardian

See also:

• Diabetes cases in the UK rise by 65% in 10 years The Independent

2.5 million men 'have no close friends'

2.5 million men 'have no close friends' Stark new research shows chances of friendlessness trebles by late middle age. The Daily Telegraph

BMA announces industrial action dates

BMA announces industrial action dates British Medical Association has announced the dates they will take industrial action, over the ongoing contract reform dispute with the Government. NHS Employers

See also:

• Juniors' contract: industrial action dates set British Medical Association
• Response to BMA JDC announcing proposed industrial action schedule NHS Employers
• Junior doctors set to strike for three days in December, union announces  The Daily Mail
• The BMA's strike threats 'could be interpreted as a betrayal of the Hippocratic Oath' The Daily Telegraph
• Junior doctors to have first 'all-out' strike in history if ballot passes The Daily Telegraph
• The junior doctors' contract threatens research and medical progress The Daily Telegraph
• NHS strike: the junior doctors are lions led by donkeys The Daily Telegraph
• BMA confirms junior doctor strike dates for December GP Online
• Facing Jeremy Hunt's fear: an interview with a militant NHS doctor The Guardian
• Junior doctors to strike for three days in December if ballot is approved The Guardian
• Hunt condemns junior doctors' 'extreme' three-day strike proposal The Guardian
• Junior doctors strike: Action would harm vulnerable patients, says Jeremy Hunt The Independent
• Jeremy Hunt snubbed by trainee surgeons over inappropriate invitation to discuss junior doctor's strike The Independent

Devolution – silver bullet or Swiss cheese?

Devolution – silver bullet or Swiss cheese? In recent months, health has found itself caught up in government’s latest big idea – devolution. Adjectives such as ‘historic’ and ‘ground-breaking’ have been used by some to describe the deals signed so far, while others have suggested they herald the start of a ‘two-tier’ or ‘Swiss-cheese’ health service. But what does devolution really mean for the NHS? The King's Fund

Dementia: the R&D landscape

Dementia: the R&D landscape This research paper provides an overview of the current dementia R&D landscape. It begins with a brief overview of the current thinking on the reasons for successes and failures of dementia treatments, based on a selective literature review.Please note that you will need to register to access this report. Office of Health Economics

Agenda for later life 2015: a great place to grow older

Agenda for later life 2015: a great place to grow older This report assesses how public policy is meeting the needs of people in later life. It finds that while many areas of life for older people have improved – including digital inclusion and employment - progress in other areas has stalled or even gone backwards. This is most marked in health, care and wellbeing, continuing a trend found last year. Age UK

Homeopathy 'could be blacklisted'

Homeopathy 'could be blacklisted' Ministers are considering whether homeopathy should be put on an NHS blacklist of banned treatments, the BBC learns. BBC News

See also:

• Statement on Homeopathy and NHMRC Information Paper - Evidence on the effectiveness of homeopathy for treating health conditions Australian Government National Health & Medical Research Council
• Homeopathy NHS Choices
• Ban homeopathy on the NHS because there is 'no evidence it works' The Daily Mail

Benefit sanctions against people with mental health problems up by 600 per cent

Benefit sanctions against people with mental health problems up by 600 per cent Charities have warned that sanctions are making mental health problems worse. The Independent

See also:

• Huge rise in people with mental illness having benefits stopped as ‘punishment’ Metro

Jeremy Hunt aims to cut number of stillbirths and neonatal deaths

Jeremy Hunt aims to cut number of stillbirths and neonatal deaths UK ranked 33 out of 35 high-income countries in 2011 study on stillbirths, and has one of highest rates in Europe

A drive to halve the number of stillbirths and deaths among newborn babies and mothers has been launched by health secretary Jeremy Hunt.

NHS trusts with maternity services will have to show how they are performing, and new data on stillbirth and neonatal death will be published at trust level so results can be compared. Continue reading... The Guardian

See also:

• New ambition to halve rate of stillbirths and infant deaths Department of Health

NHS misses key targets in run-up to busy winter period

NHS misses key targets in run-up to busy winter period Number of patients seen within four hours at lowest since targets were introduced as hospitals face surge of cases over winter

The NHS in England missed several key targets for A&E admissions, cancer referrals, ambulance response times and NHS 111 calls in September as it braces itself for a busy winter period.

Against a target of 95%, 93.4% of patients attending emergency departments were seen within four hours in September. The figure was 94.3% the previous month. The A&E data for September is often cited as an indicator of pressure on the NHS as it prepares for winter. Continue reading... The Guardian

See also:

• Winter NHS pressures 'bite early' BBC News
• NHS Hospitals forced to turn patients away as bedblocking hits record high The Daily Mail
• NHS figures reveal record number of patients kept in hospital too long The Independent

Hundreds of thousands could already be infected by new sexual disease

Hundreds of thousands could already be infected by new sexual disease A new sexually transmitted disease could already have infected hundred of thousands of people, senior doctors have warned. The Daily Telegraph

See also:

• Scientists identify new STD that could affect hundreds of thousands of adults - and it often has NO symptoms The Daily Mail
• Hundreds of thousands of British adults could have newly-identified sexually transmitted infection The Independent

Mental health services take a 'leap in the dark' on patient care

Mental health services take a 'leap in the dark' on patient care Large-scale changes to mental health services are a ‘leap in the dark’ and are having a negative impact on patient care, says a briefing published today by The King’s Fund.

See also:

• Mental health under pressure (briefing) The King’s Fund
• Mental health cuts 'hitting patients' BBC News
• Mental health patients 'at risk' due to budget cuts, leading think tank warns The Daily Telegraph
• Mental health budget cuts putting services under 'huge pressure' The Guardian

Place-based systems of care: A way forward for the NHS in England

Place-based systems of care: A way forward for the NHS in England The NHS in England is facing growing financial and service pressures at a time of rising demand. This paper proposes a new approach to tackling these challenges. It argues that NHS organisations need to move away from a ‘fortress mentality’ whereby they act to secure their own individual interests and future, and instead establish place-based ‘systems of care’ in which they collaborate with other NHS organisations and services to address the challenges and improve the health of the populations they serve. The King's Fund

See also:

Ten design principles for place-based systems of care The King's Fund

Staff engagement - necessity or luxury?

Staff engagement - necessity or luxury? Our latest blog addresses why staff engagement has never been so important and how it will help to address key NHS workforce challenges. NHS Employers

RCN members warned about contract changes

RCN members warned about contract changes The RCN is concerned about an increasing number of NHS trusts that are asking nurses to volunteer to work overtime at basic rates of pay. Royal College of Nursing

Muslim hospice care need 'to rise'

Muslim hospice care need 'to rise' UK hospices could see a significant increase in Muslim patients in the coming years, in part due to changes to the traditional family structure, a report suggests. BBC News

See also:

• Bridging the gap: strengthening relations between hospices and Muslims of Britain Woolf Institute

NHS v ministers: A case of deja vu?

NHS v ministers: A case of deja vu? Article looks at the current political situation of the NHS and Conservative party policy. BBC News

'Alarm' as patients shun flu jab

'Alarm' as patients shun flu jab Doctors have expressed alarm at a seemingly sharp fall in the number of people having the seasonal flu jab. BBC News

See also:

• Thousands of patients risking their health by ‘shunning’ flu jab, say family doctors Royal College of General Practitioners
• 1000s shunning flu jab as Doctors warn warm weather is delaying 'at risk' groups The Daily Mail
• Thousands risking health by shunning flu jab, warn GPs The Guardian

Failure to resolve juniors’ contract ‘will destabilise NHS’

Failure to resolve juniors’ contract ‘will destabilise NHS’ RCGP stays firm in wholehearted support for juniors and calls for fresh negotiations. OnMedica

Ebola nurse Pauline Cafferkey released from London hospital after full recovery

Ebola nurse Pauline Cafferkey released from London hospital after full recovery The 39-year-old Scot has been transferred to Glasgow's Queen Elizabeth University Hospital to continue her recovery. The Independent

Twitter hashtags can identify outbreaks of norovirus and food poisoning

Twitter hashtags can identify outbreaks of norovirus and food poisoning Experts at the Food Standards Agency (FSA) said a trial found they were able to identify outbreaks two weeks earlier than the normal reporting process through GPs. The Daily Mail

GPs given control of NHS budgets paid their OWN companies £2.4bn of taxpayers' money, major investigation reveals

GPs given control of NHS budgets paid their OWN companies £2.4bn of taxpayers' money, major investigation reveals Clinical Commissioning Groups, who 'buy' healthcare services for their local area, awarded 437 contracts to companies their board members owned or worked for, the BMJ has found. The Daily Mail

See also:

• General practice commissioning: in whose interests? The BMJ

​Jeremy Hunt has torn up social contract between junior doctors and the state

​Jeremy Hunt has torn up social contract between junior doctors and the state Doctors give a lifetime of work to the NHS in return for job security and fair terms and conditions – but the proposed new contract breaks bond of trust

As doctors, we embark on a 40-year-plus career in the NHS knowing full well that work life is going to be tough. Long hours, a low starting salary compared to other professions (earning £23,000 a year, compared with the national average salary of £27,000), high levels of stress, regularly doing extra work for no extra pay, and emotionally difficult experiences with sick and dying patients await us.

Although it is also extremely rewarding and a privilege to serve and be trusted by the public, amedical career takes its toll on work-life balance. Doctors have high rates of mental health problems and alcohol dependency. Family breakdown is common. Continue reading... The Guardian

NHS unlikely to get large funding boost this year, says Jeremy Hunt

NHS unlikely to get large funding boost this year, says Jeremy Hunt Health secretary tells NHS managers to expect ‘most difficult spending review in a generation’ ahead of autumn statement

Jeremy Hunt has warned the NHS that it is unlikely to get a significant boost to its budget in George Osborne’s forthcoming spending review, but hinted that ministers have recognised that additional cuts to social care would only put further strain on frontline health services.

Speaking to an audience of 500 NHS bosses, the health secretary sought to lower expectations that the chancellor will be able to hand the NHS a sizeable down payment on the £8bn the government has sought to provide by 2020 in his autumn statement on 25 November. Continue reading... The Guardian

Costly care homes may not be the best, league tables reveal

Costly care homes may not be the best, league tables reveal The first national league tables comparing cost and quality of care homes shows that the places which charge the most do not always offer the best care. The Daily Telegraph

GP super-practice to run 'front door' at busiest A&E in England

GP super-practice to run 'front door' at busiest A&E in England A GP super-practice is set to take over the the busiest emergency department 'front door' in the NHS. University Hospitals of Leicester NHS Trust working with the three Leicester, Leicestershire and Rutland CCGs appointed the Corby-based GP super-practice Lakeside Healthcare. GP Online

The Care Collapse: The imminent crisis in residential care and its impact on the NHS

The Care Collapse: The imminent crisis in residential care and its impact on the NHS Research assessing the state of the residential care industry, including an analysis of its future financial viability.

We do not believe it is an understatement to say that Britain’s residential care sector is in crisis. Providers are being faced with an unsustainable combination of declining real terms funding, rising demand for their services, and increasing financial liabilities. Our research projects a funding gap of over £1 billion for older people’s residential care alone by 2020/21, which could result in the loss of around 37,000 beds. This is greater in scale than the collapse of Southern Cross in 2011, which affected 31,000 older people.

Given the perilous state of the industry, there is no private sector provider with the capacity to take in the residents who would be affected by the loss of other providers’ beds. Consequently we believe the worst outcome is the most likely: that the vast majority of care home residents will end up on general hospital wards. We project that if all these care home lost beds were to flow through to hospitals in this way, the annual cost to the NHS would total £3 billion. ResPublica

See also:

• UK care home sector 'could lose 10% of beds in five years' The Guardian
• Care homes cash crisis could see collapse of residential care within five years, says study The Independent

Empower staff to improve staff engagement

Empower staff to improve staff engagement Learn how the George Eliot trust greatly improved its staff engagement scores by letting staff create the vision and values of the organisation. Case study from NHS Employers

‘Outdated stigma’ preventing parents from seeking life-saving mental health support

‘Outdated stigma’ preventing parents from seeking life-saving mental health support New survey reveals that new parents are experiencing depression or anxiety without professional support because they feel too afraid to seek help. Royal College of Nursing

NHS pay: 50,000 earn £100,000 or more

NHS pay: 50,000'earn £100,000 or more' There are more than 50,000 people in the NHS who earned more than £100,000 in 2013-14, an investigation by the Taxpayers' Alliance and Daily Mail shows. BBC News

See also:

• EXCLUSIVE: NHS boss made you pay for cancelled safari... and the hospital chief who put £2,000 Ibiza trip on expenses: Day two exposing the scandal of Britain's public sector fat cats The Daily Mail
• 50,137 NHS staff on £100,000 or more The TaxPayers' Alliance

Exclusive: GMC on track to hit three-year GP revalidation target

Exclusive: GMC on track to hit three-year GP revalidation target The GMC is on track to hit its target of revalidating all GPs who were on its register in December 2012 by the end of March 2016, official statistics suggest. GP Online

HCA International Limited could be forced to sell one of its hospitals due to market dominance, says watchdog

HCA International Limited could be forced to sell one of its hospitals due to market dominance, says watchdog Competition watchdog says its market dominance means insurance firms are being overcharged. The Independent

See also:

• Private healthcare market investigation: provisional findings and remedies Competition and Markets Authority

End the macho culture keeping women from the top of NHS

End the macho culture keeping women from the top of NHS It is not long hours or work-life balance fears that keep women from seeking senior roles but the behaviour of white men in grey suits

Women make up the majority of the healthcare workforce, and there are more women than men in junior positions in NHS finance, yet they are still underrepresented in the senior financial ranks, and especially on boards. While women are slowly smashing the glass ceiling across other industries why is it that women in the NHS sometimes struggle to reach the top? For a fluid organisation that prides itself on moving with the times, it is disappointing to see.

Balanced boards, whether that’s relative to experience, background, race or gender, mean better boards, and an organisation should always reflect the people it serves. Yet there seems to be a growing acceptance that women, while excelling in their professional careers and proving to be equally capable as their male counterparts, are still falling short of reaching the top echelons of the UK healthcare system. Continue reading... The Guardian

Gay men need clear information about ‘chemsex’, not messages about morality | Marco Scalvini

Gay men need clear information about ‘chemsex’, not messages about morality | Marco Scalvini When health professionals and the media talk about gay sex as an emergency health issue, they may actually encourage risky behaviour.

In the past week the public has been alerted to “risky behaviours” among gay men in London. Triggered by an editorial in the BMJ, the media has been warning of the “dangers of chemsex”, an activity labelled an “increasing risk to public health”. While there is undoubtedly an issue here, we need a strategy for dealing with the dangers of chemsex that works, rather than one that appears to favour transmitting a moral message instead of offering straightforward information.

Drug abuse and HIV continue to present profound challenges, but a climate of moral panic is counter-productive Continue reading... The Guardian

County Council Cabinet To Consider Wellbeing Company Business Case

County Council Cabinet To Consider Wellbeing Company Business Case The business case for the new Wellbeing Community Interest Company (CIC) is set to be discussed at Northamptonshire County Council’s cabinet meeting on the 10th November 2015.

Northamptonshire County Council, Northamptonshire Healthcare NHS Foundation Trust and the University of Northampton are working together to form the new company, which will bring together services and expertise that enable people to feel healthier and better about themselves. About My Area

Delayed transfers of care: join the queue

Delayed transfers of care: join the queueDelayed transfers of care, where patients are ready to return home or transfer to another form of care but still occupy a hospital bed, are a hot topic of discussion right now – whether because ofmoney, impact on patient experience or hospital flow. The publication later this week of the findings of NHS Providers’ Right Place, Right Time Commission will generate further debate.

Before the Commission puts forward its views on what good practice around delayed transfers of care looks like, let’s consider the current situation. The King's Fund

Guidance: Giving adults voice, choice and control in social care

Guidance: Giving adults voice, choice and control in social care This document provides guidance on how registered nurses, care and support staff can enable relationship-centred care, and how they can work with others to achieve personalised care and support.

The guidance is for staff across a range of care settings, including care home staff and carers who look after people in their own homes. Department of Health

Junior doctors industrial action

Junior doctors industrial action The latest information and guidance to help employers plan for industrial action as a result of the government proposals to introduce new contracts for junior doctors. NHS Employers

Managing adult malnutrition in the community: a spotlight on information, help and support available for patients and carers in England

Managing adult malnutrition in the community: a spotlight on information, help and support available for patients and carers in England This report outlines the results of a survey looking into the growing issue of malnutrition. It found that there are currently more than three million people in the UK who are either malnourished or at risk of malnutrition. The report argues that substantial savings to the NHS could be made if malnutrition is prioritised, estimating that £13 billion is spent annually on treatment for malnutrition. The Patients Association

Dead on arrival? Evaluating the Public Health Responsibility Deal for alcohol

Dead on arrival? Evaluating the Public Health Responsibility Deal for alcohol The government's flagship public health programme was launched in 2011 and brought together commercial organisations, academics, public bodies and non-government organisations to commit to a set of non-binding pledges to reduce health harms. This report evaluates the success of this programme in reducing alcohol-related harm and highlights failures of the policy's effectiveness and implementation. Institute of Alcohol Studies

Do NHS healthcare commissioners produce the outcomes they hope to achieve?

Do NHS healthcare commissioners produce the outcomes they hope to achieve? Commissioners made marginal investments in specific health conditions and services with the aim of improving a wide range of outcomes. There was little evidence of impact on the limited number of outcomes measured. BMJ Open

No hard evidence champagne can prevent dementia

No hard evidence champagne can prevent dementia"Drinking three glasses of champagne per week could help stave off dementia and Alzheimer's disease," the Daily Mirror reports. But before you break out the Bolly, you should know the study that prompted this headline was on rats.

The study that forms the basis of these reports was actually published in 2013, but apparently recently went viral on social media. NHS Choices

How much money for health?

How much money for health? The head of NHS England Simon Stevens has warned that "the rubber will really hit the road" for the NHS in England in the next financial year 2016/17 and the year after.

Even by the standards of normal spending round rhetoric, Mr Stevens' comments will raise eyebrows in Whitehall. There is nothing new about high spending departments defending their territory in the face of pressure for economies from the Treasury. But it seems that even in negotiations over a protected budget like health, stress levels are rising. BBC News

Call for overhaul of child 'fat letters'

Call for overhaul of child 'fat letters' Public health experts say the "fat letters" posted to parents to tell them if their child is overweight are crude and unhelpful and need an overhaul. BBC News

See also:

• Reform or scrap the ‘fat letter’ to parents Royal Society for Public Health
• Tackling the UK's childhood obesity epidemic (position paper) Royal Society for Public Health
• Parents of obese children should get healthy food vouchers, experts say The Guardian

Exclusive: GPs face CQC fees proportionally five times higher than hospitals

Exclusive: GPs face CQC fees proportionally five times higher than hospitals GP practices will be forced to hand over a three to five times larger proportion of their annual funding than NHS trusts for CQC registration once a controversial fee hike takes effect, GP Online can reveal.

Royal College sets out standards for cosmetic surgeons

Royal College sets out standards for cosmetic surgeons From next year surgeons will be able to apply for certification to perform cosmetic procedures. OnMedica

See also:

• Cosmetic Surgery: Certification updates Royal College of Surgeons

Leading causes of death revealed: Cancer accounts for almost a third of deaths while heart disease and dementia were leading causes for men and dementia in women

Leading causes of death revealed: Cancer accounts for almost a third of deaths while heart disease and dementia were leading causes for men and dementia in women Figures released by the Office for National Statistics for England and Wales showed the proportion of dementia deaths in women rose from 12.2 per cent in 2013 to 13.4 per cent last year. The Daily Mail

See also:

• Deaths Registered in England and Wales 2014 Office for National Statistics

George Osborne skews spending towards health and elderly people

George Osborne skews spending towards health and elderly people Spending review on 23 November is expected to shift funding away from education and economic development, within overall cuts to state budget

George Osborne’s decade-long redesign of the British state will result in 44% of state spending going on health and elderly people, the highest proportion since comparable records began in the 1990s.

As the chancellor hailed the first decisions in the forthcoming spending review, new research from a thinktank reveals how these two areas increasingly dominate public finances, having risen by a quarter in the past decade. Continue reading... The Guardian

Lives must not be put at risk

Lives must not be put at risk With the Government's Spending Review due to in weeks, the Care Quality Commission's Chief Inspector of Adult Social Care, Andrea Sutcliffe, sets out her four challenges for the care system. The Daily Telegraph

Social care: a future we don’t yet know

Social care: a future we don’t yet know Next month the government will set out its plans for public service spending through to 2020. As John Appleby explained in his recent blog, the likely outlook is likely to be the largest sustained fall in NHS spending as a share of GDP in any period since 1951. But what about social care?

Care services minister Alistair Burt recently told local authority chiefs that ‘funding is still unclear…I will find out what the funding is when you find out, when the Chancellor stands up in Westminster to deliver the Autumn Statement.’ While we are waiting, our analysis of past trends and future projections for social care makes disturbing reading.

In the 15 years to 2009, local authority net spending on adult social care for all age groups increased by an average of almost 6 per cent a year over and above inflation (figure 1). But because social care forms part of local government spending – which, unlike the NHS, was not ring-fenced in the 2010 Spending Review – this trend has reversed sharply over the past five years. Spending has dropped by an average of 2.2 per cent a year since 2009.

Money has been transferred from the NHS budget to social care (reaching £1 billion last year), which has helped a bit. Without this, the real-terms fall would have been 3.6 per cent. Most of this transferred money came from the NHS’s average annual real-terms increase of 0.84 per cent. Understandably, many are worried about further reliance on an increasingly cash-strapped NHS to prop up social care. The King's Fund

Does the NHS need more ratings?

Does the NHS need more ratings? Last week, Jeremy Hunt announced the government’s plans to introduce Ofsted-style ratings for clinical commissioning groups (CCGs), to help fill what he called the ‘transparency gap’ in the NHS. He said the ratings would help the public to understand the quality of their local services and how this compares with other places. But are more ratings really what the NHS needs?

Drawing on the findings of our recent review for the Department of Health on measuring the performance of local health systems, we would suggest there are at least five important questions to be asked about these plans. The King's Fund

Employee factsheet on state pension changes now available

Employee factsheet on state pension changes now available The state pension is changing from 6 April 2016 which will have implications for NHS staff.

This short, informative factsheet will help staff understand the changes, including who will be affected and where they can find more information. NHS Employers

Gene editing breakthrough in treating baby's leukaemia

Gene editing breakthrough in treating baby's leukaemia"Baby girl is first in the world to be treated with 'designer immune cells'," The Guardian reports.

Pioneering work carried out at Great Ormond Street Hospital made use of a new technique known as genome editing.

The girl, one-year-old Layla Richards, developed acute lymphoblastic leukaemia (ALL) when she was five months old.

ALL is cancer of the white blood cells and although it is generally rare, it is one of the most common childhood cancers, affecting around 1 in 2,000 children.

The outlook for ALL is usually good, with around 85% of children achieving a complete cure. However, this was not the case with Layla, as she failed to respond to conventional treatments. The staff treating Layla at Great Ormond Street Hospital sought permission to try a new technique, previously only used in mice, called genome editing.

Heads 'calling 999 over mental health'

Heads 'calling 999 over mental health' Schools are having to call the emergency services to get treatment for mentally ill pupils because of a lack of basic provision, head teachers say. BBC News

See also:

• Councils spending just 1% of health budgets on mental health The Guardian

Arriva may face SFO fraud inquiry over NHS deal

Arriva may face SFO fraud inquiry over NHS deal Ministers have hinted that the transport giant Arriva could be subjected to a Serious Fraud Office inquiry after it inflated figures on an NHS contract. The Independent

NHS mental health trust admits whistleblower who spoke out about bullying acted in good faith

NHS mental health trust admits whistleblower who spoke out about bullying acted in good faith Dr Hayley Dare was ridiculed after revealing culture of bullying and harassment at West London Mental Health NHS Trust. The Independent

A third of home-care providers fail to meet even basic standards

A third of home-care providers fail to meet even basic standards Failing home-care providers have been warned by a Government Minister they must 'shape up or shut down' after it was found nearly a third of agencies are failing to meet basic standards. The Daily Mail

See also:

• What happens to older people who can't afford good care? The Guardian

NHS facing financial collapse without more cash, warns London trust chief

NHS facing financial collapse without more cash, warns London trust chief Chair of south-west London trust says hospitals will be unable to pay staff next year unless Jeremy Hunt doubles annual funding rise to £4bn

The NHS is gripped by “an accelerating financial disaster” that could mean hospitals are unable to pay their staff next year, one of the service’s bosses has said.

Christopher Smallwood, chairman of St George’s University Hospitals NHS foundation trust, which serves 1.3 million people in south-west London, claims that years of underfunding have left hospitals short of staff and unable to meet waiting time targets for cancer and A&E care. Continue reading... The Guardian

See also:

• As chair of a trust, I’m speaking out. The NHS is headed for financial ruin | Christopher Smallwood The Guardian
• NHS meltdown this winter The Daily Telegraph

Doctors who left NHS for Australia: ‘More cash, fewer hours, less pressure’

Doctors who left NHS for Australia: ‘More cash, fewer hours, less pressure’ As the row over junior doctors’ contracts intensifies, thousands of NHS staff are applying to work abroad. Here three who have moved explain why they went

Sarah Wollaston, chair of the Commons health committee, revealed last month that her daughter, a junior doctor, and eight of her friends had all quit the NHS to find work in Australia. It’s a disturbing trend: but as the dissatisfaction over hours and conditions in the NHS grows, it may be one we have to get used to.

Australia has long attracted doctors from Britain. Depending on their seniority, doctors can earn up to 50% more in Sydney or Melbourne, despite generally working less overtime. With the health secretary, Jeremy Hunt, now threatening to impose a tough new contract on junior doctors – one that would see their working hours increased and pay cut – the lure of Australia is growing. Continue reading... The Guardian

Jeremy Hunt cannot escape responsibility for the NHS's mounting problems

Jeremy Hunt cannot escape responsibility for the NHS's mounting problems The health secretary is a skilled politician who has positioned himself as the patients’ champion, but his days in the post appear to be numbered.

Jeremy Hunt’s confrontation with junior doctors over seven-day working adds to a growing list of problems beginning to engulf the health secretary. Will he still be at the department’s Richmond House headquarters at the end of this parliament?

It is just over three years since Hunt replaced Andrew Lansley. It quickly became clear why David Cameron was so determined to keep Hunt in government despite the controversy surrounding his handling of News Corporation’s bid for BSkyB while he was culture secretary. Immediately burying any mention of the toxic health reforms, he shrewdly repositioned the role of health secretary from representing the NHS to government, to representing the interests of patients to the NHS. Continue reading... The Guardian

Experts worried pre-natal blood test might lead to sex-selective abortions

Experts worried pre-natal blood test might lead to sex-selective abortions Government officials are concerned NIPT test might be used by people who may want to abort a foetus because of a baby's sex. The Daily Telegraph

Elderly at Northampton care home only offered drinks between 7am and 5pm, inspectors find

Elderly at Northampton care home only offered drinks between 7am and 5pm, inspectors find Residents at a Northampton care home were only offered something to drink during a 10-hour period, an inspection revealed. Northampton Chronicle and Echo

Help for unemployed people in Northampton suffering depression and low self-esteem

Help for unemployed people in Northampton suffering depression and low self-esteem New courses to help unemployed people who have low self-esteem and mental health issues are starting later this month. Northampton Chronicle and Echo

The NHS, the Spending Review and George Osborne

The NHS, the Spending Review and George Osborne George Osborne has the aura of a man who is the master of all he surveys. It is an aura that has been hard won but could be easily lost as the government’s reverse in the House of Lords over tax credits shows. The Chancellor faces far greater challenges in other areas of public spending as the Spending Review nears completion.

The outcome of the Spending Review, to be announced on 25 November, will reveal the government’s priorities for public services for this parliament. The broad outlines of further deep cuts in most forms of public spending with the exception of protected areas such as health care are well known. The Conservative party made its intentions on deficit reduction crystal clear during the election campaign while also limiting its room for manoeuvre by pledging not to increase headline tax rates. The King's Fund

Improving mental health outcomes for young people: the perspective of a GP trainee

Improving mental health outcomes for young people: the perspective of a GP trainee During my first few weeks as a GP trainee, I met a young lady who had recently been diagnosed with a serious, long-term condition. Walking into the consultation room, she sat down with her fringe partially covering her eyes. I started by asking her how she had been since her last visit. Slowly, she began telling me how her diagnosis had made her feel.

Fifteen minutes into the consultation, she grew more at ease. She revealed that she had become increasingly low and was finding it difficult to sleep. She was now considering dropping a class that she loved. Her antidepressants, it seemed, had not done the trick.

At the end of our 30-minute slot, together we made a plan to organise counselling. That evening, I contacted her specialist nurse, completed a referral to the psychologist and booked a follow-up consultation. As I finished off my paperwork, one thought lingered: as a new GP trainee, my appointments are 30 minutes long; in a few short months they'll be down to just 10. What would we have achieved in 10 minutes? The King's Fund

Guidance: ECHR Article 2: investigations into mental health incidents

Guidance: ECHR Article 2: investigations into mental health incidents This guidance is for NHS organisations deciding whether to carry out an independent investigation to satisfy the state’s obligations under Article 2 of the European Convention on Human Rights. NHS bodies implicated in serious incidents may be considered ‘state agents’ for the purposes of Article 2.

The procedures to be followed when managing a serious incident are set out in the NHS England Serious Incident Framework – Supporting learning to prevent recurrence.

This document, when read together with the framework, replaces the Department of Health guidance ‘Independent investigations of adverse events in mental health services’, published in 2005.

New quick guide will free up vital hospital services

New quick guide will free up vital hospital services A new quick guide, ‘Better Use of Care at Home’, has been developed to help people home from hospital. It contains practical tips, case studies and ideas to improve processes, relationships and the use of care at home. NHS England

Shape of Caring Review engagement film launched

Shape of Caring Review engagement film launched A film highlighting some of the key themes emerging from the engagement phase of the Shape of Caring Review has been launched on the Health Education England website.

GMC advice for doctors in England considering industrial action

GMC advice for doctors in England considering industrial action The British Medical Association (BMA) is about to ballot its members who are doctors in training in England about taking industrial action over a new contract proposed by the UK Government. General Medical Council

Viewpoint: Cuts to social care are damaging the NHS

Viewpoint: Cuts to social care are damaging the NHS Restrictions to council-funded adult social care means fewer people are getting the support they need in their home, argues Tom Shakespeare. GP Online

Seven-day NHS: Most patients prefer seeing GP during the week, says study

Seven-day NHS: Most patients prefer seeing GP during the week, says study Study calls into question Government’s flagship policy of introducing a seven-day health service. The Independent

See also:

• Weekend opening in primary care: analysis of the General Practice Patient Survey British Journal of General Practice
• RCGP response to BJGP paper on seven day working Royal College of General Practitioners
• Sunday GP opening 'not in demand' BBC News
• Routine GP opening on Sundays provides little benefit, study shows GP Online
• Patient survey finds 81% happy with GP hours The Guardian

Transforming learning disability care means valuing all citizens

Transforming learning disability care means valuing all citizens A new national plan to improve learning disability services is right, but we’ve heard it all before – it’s time for real change and it won’t be cheap.

The publication of a national plan to transform learning disability services, and particularly for people with a learning disability and/or autism whose behaviour challenges, is welcome, overdue and ambitious.

The background to the latest plan is familiar, particularly with the scandal of Winterbourne View uncovered by BBC’s Panorama in 2011, which highlighted both individual abuse and neglect, and raised awareness of the much wider issue of long-term hospitalisation. But the need to commission appropriate services has long been recognised, and is a particular concern for young people with learning disabilities and complex needs when transitioning to adult services. This is when out-of-area placements often occur due to a lack of alternative local provision.

Children, young people and adults with a learning disability and/or autism have the right to the same opportunities as anyone else to live satisfying and valued lives, and to be treated with dignity and respect. They should have a home within their community, be able to develop and maintain relationships, and get the support they need to live healthy, safe and rewarding lives.

Developing good local services will not be cheaper, overall, than institutional care, but it will be more efficient because it will achieve more. If local services are not developed, then a trickle of out-of-area placements will become a rush as more people are excluded from mainstream community services by being defined as unmanageable in the community. Large amounts of money will be tied up in buying less good services. The policy of community care will be said to have failed.

Some will have a mental health problems which may result in them displaying behaviour that challenges. Some, often with severe learning disabilities, will display self-injurious or aggressive behaviour unrelated to any mental health condition. Some will display behaviour which can lead to contact with the criminal justice system. Some will have been in hospital for many years, not having been discharged when NHS campuses or long-stay hospitals were closed. The new services and support we put in place to support them in the community will need to reflect that diversity. Continue reading... The Guardian

See also:

• Bubb report into care of people with learning disabilities: views from the sector The Guardian

Two deaths possibly linked to 'Hunt effect', study suggests

Two deaths possibly linked to 'Hunt effect', study suggests Research suggests some patients may be avoiding going to hospital at the weekend because of health secretary’s statements about inadequate NHS staffing levels

Two people in need of urgent medical attention died last month after they did not go to hospital at a weekend because they wrongly believed there would be too few doctors on duty and that they would be at risk of dying, research claims. Almost a third (32%) of the 40 patients studied, who all held off seeking NHS treatment for that reason, suffered “long-term, irreversible morbidity” (an increased chance of dying) as a direct result of their delay, their doctors say.

In addition, more than four out of five (82%) of the patients had a worse outcome than if they had sought help the day their health deteriorated, while the delay could have proved life-threatening in 90% of them, the study found. They included an older person who had fallen over and broken a limb but stayed in bed over the weekend, despite having a fracture and being in pain because paracetamol gave her too little relief, and only sought help on the Monday. Continue reading... The Guardian

British baby given genetically-edited immune cells to beat cancer in world first

British baby given genetically-edited immune cells to beat cancer in world first A British baby has become the first in the world to receive genetically modified immune cells from a donor and is now cancer free. The Daily Telegraph

See also:

• 'Designer cells' reverse baby's cancer BBC News
• VIDEO: 'Miracle' genetic therapy saves baby BBC News
• World first as baby girl battling leukaemia is saved by 'miracle' treatment: Genetically-modified cells which 'hunt out and kill the disease The Daily Mail
• Layla Richards: One-year-old girl becomes world's first person to receive therapy to cure incurable cancer The Independent

Is a brisk walk better for losing weight than going to the gym?

Is a brisk walk better for losing weight than going to the gym? "A brisk 30-minute walk five days a week is more effective than any other form of exercise for keeping weight down," The Times reports. That is the reported conclusion of two researchers who looked at data from the annual English Health Surveys from 1999 to 2012.

As expected, they found people who regularly walk briskly for half an hour five days a week were likely to have a lower body mass index (BMI) than people who are less active.

The study found women and those over the age of 50 were most likely to have a lower weight if they walked regularly. By walking, the researchers mean brisk walking that raises your heart rate and makes you sweat slightly, not a gentle stroll.

Walking was also linked to having a smaller waist size – although, for men, sport and other forms of exercise were more strongly linked to waist size than walking. Sport and exercise were also linked to a lower BMI, although the link was not as strong as it was for walking.

However, this study does not seem to have compared the effects of the two types of activity directly, so we cannot say for sure – as many in the UK media have done – that walking is more effective than other types of exercise. NHS Choices

Hospital trust admits deaths charges

Hospital trust admits deaths charges The NHS trust that ran Stafford Hospital pleads guilty to criminal charges in relation to four deaths. BBC News

Invest in pathology services to boost diagnosis and cut costs, urges report

Invest in pathology services to boost diagnosis and cut costs, urges report Investment in pathology services would boost the quality of diagnosis, cut NHS costs and narrow health inequalities, says The Royal College of Pathologists. OnMedica

See also:

• Pathology and the NHS Five Year Forward View Royal College of Pathologists

The cancer drugs fund lottery: Relief as life-extending breast cancer drug is one of seven spared the chop - but nine more will be axed

The cancer drugs fund lottery: Relief as life-extending breast cancer drug is one of seven spared the chop - but nine more will be axed  Some 4,100 cancer patients will miss out on breakthrough cancer drugs in England next year as a result of the cuts, down from the 5,500 who would have missed out if some drugs had not been saved. The Daily Mail

See also:

• Cancer drug makes it back on NHS fund BBC News
• Breast cancer drug Kadcyla to remain on NHS after manufacturer lowers price The Guardian

Hospital doctor found guilty of manslaugher after blunders left a six-year-old boy dead

Hospital doctor found guilty of manslaugher after blunders left a six-year-old boy dead Jack Adcock, who had Down's syndrome and a heart condition, was misdiagnosed by "incompetent" Dr Hadiza Bawa-Garba. The Daily Telegraph

NHS: Junior doctors to proceed with strike ballot after Jeremy Hunt's last-minute proposals branded misleading

NHS: Junior doctors to proceed with strike ballot after Jeremy Hunt's last-minute proposals branded misleading The BMA said the amended proposals also failed to address concerns around the removal of safeguards. The Independent

See also:

• BMA presses ahead with juniors' ballot British Medical Association
• News story: Junior doctors' contract offer Department of Health
• Policy paper: Junior doctors' contract offer: main points Department of Health
• Statement to Parliament: Junior doctors' contract Department of Health
• Professor Wendy Reid responds to junior doctor contract offer Health Education England
• Junior doctors' contract offer NHS Employers
• Sir Bruce Keogh on junior consultant contract debate NHS England
• Response to Secretary of State announcement on junior doctor's contract Royal College of General Practitioners
• BMA refuses to re-enter contract talks BBC News
• Junior doctors throw 15% pay rise offer back in Jeremy Hunt's face The Daily Mail
• Junior doctors reject 11pc pay rise and prepare for strike ballot The Daily Telegraph
• The NHS is in trouble. Doctors should help, not fight over pay The Daily Telegraph
• BMA tried to gag regulator from issuing strike advice The Daily Telegraph
• Junior doctors are victims of an NHS that's broken beyond repair The Daily Telegraph
• Jeremy Hunt's 11% junior doctor contract offer 'megaphone diplomacy', says BMA GP Online
• Junior doctors reject 'misleading' pay offer and criticise Jeremy Hunt The Guardian
• Jeremy Hunt: I cannot negotiate on manifesto promise of 24-hour NHS The Guardian
• Junior doctors ballot over strikes as pay offer branded 'fatally flawed' The Guardian
• Jeremy Hunt’s ‘pay rise’ offer to junior doctors is nothing of the sort | Letters The Guardian
• Junior doctors claim Jeremy Hunt's 11% pay rise will be a 'pay cut' of 26% The Independent

NHS: UK now has one of the worst healthcare systems in the developed world, according to OECD report

NHS: UK now has one of the worst healthcare systems in the developed world, according to OECD report Hospitals so under equipped that people are dying needlessly because of a chronic lack of investment. The Independent

See also:

• Health at a Glance 2015 OECD Indicators OECD
• UK healthcare 'trails other nations' BBC News
• How the UK is the unhealthy man of Europe: NHS needs 50,000 more nurses and 26,500 doctors costing £5bn to bring it up to standard of Western neighbours The Daily Mail

Fat Chance? Exploring the evidence on who becomes obese

Fat Chance? Exploring the evidence on who becomes obese A new study blows apart previous simplistic approaches to obesity. The research paper, ‘Fat Chance?’ which examines the wealth of current knowledge and data on obesity, addresses one crucial question: ‘Who exactly is becoming obese?’ 2020health

See also:

• 2020health say misery in middle age makes us pile on the pounds The Daily Mail

Valuing staff through recognition schemes

Valuing staff through recognition schemes Staff recognition schemes are a good way of helping staff to feel valued by the organisation they work for. NHS Employers

Hunt pay offer in junior doctor row

Hunt pay offer in junior doctor row Health Secretary Jeremy Hunt says the government's proposed new contract for junior doctors in England will include an 11% increase in their basic pay. BBC News

See also:

• BMA responds to Guardian story on Jeremy Hunt's offer to junior doctors British Medical Association
• Junior doctors' contract offer Department of Health
• VIDEO: Hunt: 'Good deal for doctors and patients' BBC News
• VIDEO: Junior doctor's frontline video diary BBC News
• Jeremy Hunt offers pay rises of up to 15% to halt doctors’ strike The Daily Mail
• Junior doctors offered 11pc pay rise to head off strike The Daily Telegraph
• Jeremy Hunt offers junior doctors 11% pay rise in bid to end dispute The Guardian
• Junior doctors offered 11% pay rise as Jeremy Hunt bids to avoid strike The Independent

Trainees and 1,000 existing GPs will count towards 2020 workforce target, MPs told

Trainees and 1,000 existing GPs will count towards 2020 workforce target, MPs told A government pledge to deliver an extra 5,000 GPs in England by 2020 will be met by including trainees and persuading 1,000 existing GPs to delay retirement or return from career breaks, an NHS training official has admitted. GP Online

CQC fee hike slammed by GPs and health providers

CQC fee hike slammed by GPs and health providers Plans for fee rise 'damaging to patient care' OnMedica

See also:

• BMA criticises “wholly unjustified" proposals to increase CQC fees that could damage patient care British Medical Association
• Health and social care fees consultation Care Quality Commission 

Sex under the influence of drugs is 'causing HIV and other STI rates to soar'

Sex under the influence of drugs is 'causing HIV and other STI rates to soar' Experts writing in the British Medical Journal said people having chemsex often reported having unprotected sex with multiple partners. Doctors believe tackling it should be a health priority. The Daily Mail

See also:

• What is chemsex and why does it matter? The BMJ
• Chemsex: the alarming new trend of 72 hour drug-fuelled sex sessions The Daily Telegraph
• Chemsex should be public health priority due to HIV risk, experts say The Independent

NHS doublespeak drove me away from mental health nursing

NHS doublespeak drove me away from mental health nursing Euphemisms such as ‘cost-improvement’ and ‘management of change’ mask the disastrous impact of cutting frontline staff

Last year the infrastructure behind research delivery in the NHS was completely re-organised; a process officially referred to as “transition”. In my experience as a mental health research nurse, this has created anxiety, confusion and uncertainty, exacerbated by the nuanced way in which the NHS communicates information to its workforce.

Communication between medical professionals and patients is well-documented, but little attention is given to the corporate language used within NHS organisations; language that often appears to conceal the true meaning of what is being said. “Transition” is a case in point; a word suggestive of an evolving, organic process or a natural progression from one state to another. In reality, transition in this context meant re-structuring the entire research delivery network across England and Wales. In terms of mental health research, what emerged at the other end of this re-structure (let’s call it what it was) appears to be a costly muddle, held together by the goodwill and dedication of excellent research staff. Continue reading... The Guardian

Fixing 111 is a matter of life and death

Fixing 111 is a matter of life and death Telegraph View: Non-emergency care responses must be better. If there were a train crash in which 25 people were killed, a major inquiry would be held into the causes and the event would be the subject of media speculation for days. Yet when the deaths are attributed to a scandal in the NHS the response is far more muted. The Daily Telegraph

Abortion doctor who agreed to gender-based termination suspended for three months

Abortion doctor who agreed to gender-based termination suspended for three months A doctor who was caught by The Telegraph admitting that an abortion he was offering was tantamount to 'female infanticide' struck off for three months. The Daily Telegraph

See also:

• Birmingham doctor who agreed to abortion because foetus was a girl is suspended The Daily Mail