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2013 Q4 October-December

Health and Wellbeing Policy Update – October-December 2013

31st December 2013

A call from leading NHS organisations for a less critical, more balanced approach to the NHS, has been made in a letter to the Guardian by the leaders of 10 NHS front line organisations. They call for a new approach, after excessive criticism in 2013. 

(The letter) 

(1st Jan 2014) 

30th December 2013

Public Health England is launching a £3m anti-smoking campaign to coincide with people’s new year resolutions.

Overseas visitors and migrants are to be charged for using A&E in England it has been ‘re-announced’ after a public consultation, with higher charges for prescriptions, optical and dental care.  GP and nurse consultations will remain free.  Full details are to be published in March.

28th December 2013

Sexual health services are in danger as a result of the services being put to tender according to the British Association for Sexual Health and HIV (Bashh) and the Royal College of Physicians (RCP) who have written to all local authorities, (which since April commission these services), asking them not to expose them to competition. 

Brief review of the year for the NHS including a list of the various reports that have been produced. 

27th December 2013

Some pregnant women from overseas are avoiding maternity care because they cannot afford it according to those working with them. 

There has been an increase in the number of doctors trained in the UK but now working in A&E in Australia from 285 in 2008 to 481 last year, equivalent to two year’s A&E intake.  However, this is in the context of 36% of the 260k doctors registered with the GMC to practice here being from overseas including 1,969 from Australia.

There appears to be an increasing problem of damp in social housing with consequent health implications.  A survey of housing maintenance staff found 90% had noted increased reports of condensation dampness.  One housing association experienced a tripling of complaints about damp from 22 in November 2012 to 76 in the same month this year.  The increase is thought to be due to inability to pay for heating following welfare cuts. 

NHS England is recruiting 4 additional patient and carer members to its Clinical Reference Groups on congenital heart services, neurosciences, chemotherapy and PET-CT. 

24th December 2013

The number of people having to wait for more than a week to see a GP has risen by 10% in the last year, from 14% to 15%, according to analysis by the Royal College of GPs of the most recent GP patient survey, with 26 million people waiting at least a week. 

The risk of heart attack and stroke is better judged by build up of calcium in the arteries than cholesterol levels and blood pressure, according to US research on over 7,000 people studied for seven years.  The test for calcium tends not to be used in the NHS because of its cost. 

A rather nice collection of festive health statistics from HSCIC 

23rd December 2013

Culturally specific and family centred support helps families of Indian and Pakistani origin to lose weight and reduce the risk of diabetes in a study of 171 people in Scotland. 

NHS Trust Development Authority publishes guidance for trusts to help their long term planning. 

The annual plan review guidance for 2014/15 published by Monitor. 

21st December 2013

What is claimed to be the world’s first artificial heart has been implanted into a patient in France.  Artificial hearts are used for temporary support until a donor can be found, but this device is intended to replace the heart on a longer term basis. 

20th December 2013

NHS England publishes a guidance framework for commissioners, setting out its vision for ‘transformed, integrated and more convenient services’ in the context of significant financial challenge.  The document is, ‘Everyone Counts: Planning for patients 2014/15 to 2018/19. 

Funding allocations to CCGs for the next two years are published 

Guidance published on the Better Care Fund (previously known as the Integration Transformation Fund). 

Letter to local authorities: 

Guidance on the need for all NHS providers to have a licence from April 2014 from Monitor and exemptions that apply. 

Meeting the needs of patients: improving strategic planning in NHS Foundation Trusts, 

Bulletin for CCGs: Issue 49 

PHE Bulletin 

[Weekly update sent out ————————————————————–]

20th December 2013

NHS England is to provide £50m for at least nine pilots on improving access to GP appointments.  There is to be at least one in each region of England. 

19th December 2013

29% of disabled people affected by the bedroom tax have been refused discretionary housing payments (DHPs) in the six months from April 2013, according to a survey by the National Housing Federation.  The Government has argued that access to this fund means the bedroom tax does not discriminate against disabled people.

(20th December) Government statistics on use of discretionary housing payments:

A number of children’s charities are protesting at ONS proposals to stop producing child mortality statistics. 

Lung cancer one-year survival rates have improved with twice as many patients alive after 12 months in 2011 as 1990 according to PHE’s National Cancer Intelligence Network. 

PHE publication: ‘Health and Care Integration: making the case from a public health perspective’. 

Briefing from the Health Foundation on how the Government’s response to the Francis enquiry should be implemented, in ‘Hard Truths: Essential Actions’. 

18th December 2013

Government funding for local authorities is to be cut by 8.5% in the provisional local government finance settlement for 2014-15.  The cut is 15.9% for districts since they will not benefit from the Better Care Fund (the new name for the Integration Transformation Fund) which transfers funding from CCGs to local government.  There will be an overall reduction of 2.9% in councils’ total spending power. 

Spreadsheet of allocations: 

NHS England has rejected DH proposals for funding allocations based on age which would have penalised poorer areas.  The new funding formula takes into account population growth, deprivation and the impact of an ageing population.  All CCGs will receive increases at least matching inflation over the next two years, with more going to those with the fastest growing populations and that were previously underfunded. 

The funding allocations: 

Not as bad as expected but Yorkshire fares worst: 

The 2012 Health Survey finds that only 16% of girls and 21% of boys aged 2-15 get the recommended one hour’s exercise a day.  Of those over sixteen, 67% of men and 55% of women got the recommended two and a half hours of exercise a week.  One in five men and one in eight women drink twice the recommended daily alcohol limit.  The survey, published by HSCIC involved 8,000 adults and 2,000 children. 

Deaths from cancer have fallen by more than a fifth in the last two decades from 220 to 170 per 100k since 1990 according to Cancer Research UK.

The Government is to pay £755m to councils to provide 15 hours a week free child care to the most disadvantaged two year olds from next September. 

1.55m children will be entitled to a free school meal from next September.  The entitlement will apply to reception years 1 and 2 in state schools. 

The Trust Special Administrator has recommended that the Mid Staffordshire NHS Trust should be dissolved. 

Standards for reconfiguring women’s services are published by the Royal College of Obstetricians and Gynaecologists. 

The Guardian’s assessment of how austerity has impacted on public services over the last year. 

17th December 2013

Alcohol consumption continues to fall, according to figures from ONS, although they advise caution as these are self-reported figures.  There was a fall between 2005 and 2012 from 72% to 64% of men who said they had drunk alcohol in the last week, while the figure for women was 57% to 52%. 

Nearly 12% of girls and 5% of boys were terrified of getting fat according to interviews with parents of over 7,000 13 year olds in a study by UCL and the London School of Hygiene and Tropical Medicine.  52% of girls and nearly a third of boys were a little worried about getting fat. 

The numbers receiving emergency food aid in the South East have risen from about 1,000 to 45,000 between 2006 and 2012, according to research for an MEP. 

The number of people receiving support from social services in 2012-13 fell by 9% compared to the previous year and by 25% compared to 2007-8, according to figures from HSCIC. 

(18th December) 

New rules for paying for NHS funded services are published by Monitor and NHS England, providing more scope for local flexibility. 

HEE publishes first ever national workforce plan, for spending from September 2014. 

16th December 2013

The equivalent of 483,000 fewer elderly and disabled people have received care in the five years since the crash, according to estimates by the Personal Social Services Research Unit on behalf of the Care and Support Alliance, a group of 75 organisations.

Labour press NHS England not to change the funding formula from poorer to older areas which lead to a reduction of almost £1bn to the north and London. 

The BMA urge the government not to give Trust Special Administrators powers affecting successful hospitals. 

(18th December) Concern over Clause 118 of the Care Bill: 

15th December 2013

NHS England outlines plans for 7 day working, with consultants possibly losing the right to refuse to work at weekends, diagnostic tests to be made available and hospitals facing sanctions for not providing the same level of service on Saturdays and Sundays. Prof Sir Bruce Keogh, NHSE’s Medical Director, set out 10 new clinical standards. 

Interesting letter providing a different perspective on the risks.  You are 16% more likely to die within 30 days if you go into hospital on a Sunday compared to a Wednesday.  But if you go in on a Wednesday you have a 98% chance of being alive in 30 days, while if you go in on a Sunday the chance is 97.68%.

(17th December) report on the cost implications of seven day working: 

More needs to be done to meet the health needs of vulnerable groups according to commissioning guidance from the Royal College of GPs. 

14th December 2013

Increasing levels of obesity have led to a five fold increase in liver disease over the last decade, in addition to the other problems obesity can cause. 

13th December 2013

Ofsted consultation on the regulatory framework for inspecting children’s homes.  The Consultation runs until 21st February 2014. 

NHSE’s annual GP survey finds that 92% of patients say making an appointment with their GP is convenient. 

A series of briefing notes on integrated approaches to improving public health are published by the Faculty of Public Health. 

[Weekly update sent out ————————————————————–]

13th December 2013

There has been a 26% increase in eviction notices by social landlords in the last year, according to an Inside Housing survey of 113 social landlords. 

Winterbourne View progress report 

One in five in-patients with learning disabilities is being treated more than 100km away from home, according to the HSCIC. 

Serco is pulling out of health contracts in Cornwall and Braintree. 

Councils need more information to champion mental health according to a briefing from the Centre for Mental Health, which publishes ten questions for councillors to ask their public health teams. 

The NAO says DCLG “must improve its understanding of how funding changes and wider welfare reform will combine to affect local authorities” in a report on the localisation of council tax benefit. 

Public Health grants to local authorities and grant conditions 

NHS News: Issue 37

12th December 2013

A CQC survey is reported as finding maternity services as being ‘just not good enough’.  The survey of 23,000 women who gave birth in February follows a similar one in 2010.  Around a quarter of women had been left alone at some point in the labour or delivery that worried them: a slight rise since 2010.  About a quarter said they did not receive pain relief quickly enough or in a strong enough dose. 

‘Many people’ receive good quality GP care, but 34% of practices failed at least one of the required standards in 1,000 inspections since April, according to the CQC.  However the initial inspections were targeted at high risk practices and less than 1% of the practices inspected were subject to enforcement.  The CQC was announcing its new approach to the regulation of GPs.  Inspection teams are to include a GP, a practice manager or nurse and a trainee GP.  The aim is to visit every CCG area six monthly, inspecting a quarter of GP practices each time.

Funding for mental health has fallen by more than 2% real terms over the past two years, according to information from foi requests by Community Care and BBC News.

Government reduces councils’ data reporting, cutting the ‘single data list’ by a third, in what it says is a slashing of town hall red tape. 

Government increases councils’ data reporting, requiring councils to publish spending in a range of categories, hailed as a new wave of town hall transparency. 

Further cuts to universal credit recipients, not immediately apparent in the Autumn statement which could leave working families several hundreds of pounds a year worse off have been uncovered by the Resolution Foundation.  The cuts arise because universal credit work allowances are to stay at the same level for three years from April 2014. 

CCGs are accountable to too many different bodies according to a report in BMJ Open. 

There were 148 ‘never events’ in the six months from April to September, a similar rate as the previous year. 

Since taking over public health, councils are starting to change priorities but this is not always reflected in spending according to a report, ‘Healthy Dialogues: embedding health in local government’ by the NLGN. 

‘Improving the Public’s Health: a resource for local authorities’ published by the King’s Fund. 

Mental health outcomes information is now published in one place. 

Bulletin for CCGs: Issue 48 

11th December 2013

David Cameron has said the Government will increase its funding for dementia research from £52 to £66m between 2012-13 and 2015 with an ambition to double public, commercial and charitable research in the ten years to 2025. 

‘State of Maternity Services’ report published by the Royal College of Midwives 

‘Our Place’, the neighbourhood budget programme, is to be extended to at least 100 more areas, following a pilot in 12 areas. 

Background information on ‘Our Place’ and neighbourhood community budgets: 

The number of obese and overweight year 6 pupils has fallen slightly in the last year from 33.9% to 33.3%, according to figures from the HSCIC, although it is not clear whether this is a blip or a trend.

The Government is changing the law to allow it to reconfigure successful hospitals, rather than just a failing hospital, without the support of CCGs.  This follows the High Court decision against Jeremy Hunt when he tried to downgrade Lewisham A&E. The change comes through an amendment in the Care Bill which is due to have its second reading in the Commons next week. 

House of Commons Library briefing on the Care Bill: 

King’s Fund briefing on the Care Bill: 

10th December 2013

A fifth of people on intravenous drops have problems because of being given the wrong amount of fluid according to NICE which has produced new guidance. 

Survival from cancer has increased by 10% over 15 years but rates are much higher in the home counties than the north, according to ONS figures.–Southerners-better-chance-North.html 

Progress on implementing Cancer Outcomes Strategy:

Children of itinerant families are entitled to support, even when they move outside a council’s boundaries, according to a high court ruling, in a case brought on behalf of a three year old boy with Down’s Syndrome against Worcestershire County Council.  The family travels around in the summer providing fair ground rides but stays in one place through the winter. 

EHRC welcomes the judgement: 

WHO launches MiNDbank, a database about mental health, laws, strategies and service standards in different countries. 

NHS News: Issue 36 

9th December 2013

Harm from air pollution can happen at levels below EU prescribed safe levels according to new research. 

The maximum waiting time in an ambulance at A&E is several hours in many areas, whereas the target time is 15 minutes, according to information obtained by the BBC under foi.  However, NHSE said that while there were 4,500 delays a week of more than 30 minutes, this was down on last year.  In Wales, one ambulance was left waiting for more than 6 hours, but the average waiting time was 20 minutes. 

An audit of the ‘big society’ finds it is suffering from cuts, widening social inequalities and declining levels of trust, according to the think tank Civil Exchange.  It says it is working better in more affluent areas than in deprived communities.

Workers on low and middle incomes are experiencing the biggest fall in their living standards since the mid-19th century when records began, according to a report by the new economics foundation. 

8th December 2013

Alcohol and drug related problems are costing the NHS £607m a year according to the latest hospital admission data published by Dr Foster, with middle aged people constituting a substantial proportion of cases.  While there are problems in all socio-economic groups, they were greatest amongst the most deprived income group. 

There are more working families in poverty than non-working ones for the first time, according to a report, Monitoring Poverty and Social Exclusion 2013 by the New Policy Institute published by JRF. 

7th December 2013

Only a minority of patients are fast-tracked for investigation by cancer specialists according to a survey of 4,000 GP practices.  In about half of the practices less than half of patients were seen in the NHS target of two weeks. 

6th December 2013

ONS analysis of the census figures shows a rise in over 85 olds of 25% in a decade.  There are twice as many women as men in this age group, with 13% of women still married, but 49% of men. 

Seven new pilots on the use of personal budgets for mental health are being set up. 

Report on the NHS Constitution by the Patients Association on behalf of the All Party Parliamentary Group on Patient and Public Involvement in Health and Social Care. 

[Weekly update sent out ————————————————————–]

6th December 2013

Dr Foster annual Hospital Guide published.  Knee and hip replacements and cataract removals fall to the lowest level in five years, it is suspected to save money.

Map of changes in hips, knees and cataract operations:

16 NHS hospital trusts have higher than expected mortality rates: 

5th December 2013

Autumn statement.

  • £3bn cut to Government budgets in the next two years.  No additional cuts to local government and the NHS budget to rise in line with inflation.
  • Welfare budget (excluding unemployment and pensions) to be capped, set at the start of each parliament.
  • Continuation of pooled health and social care funding beyond 2015-16.
  • Plans to reduce the size of the state to its smallest since 1948.
  • Climate change and longer term health: fuel duty freeze; tax relief for shale gas; reducing energy companies’ obligation; energy efficiency grant for future home buyers. 

LGA briefing (links to pdf): 

Key points for local government: 

Nuffield Trust says finding 4% real terms savings in the NHS up till 2019 will probably not be possible: 

Colin Talbot blog: 

Blog, why not link the rise in the pension age to reducing health inequalities:

New maternity statistics show teenage pregnancies at their lowest since 1969.  Teenage pregnancies fell 8% in a year and 28% since 2007-8.

The figures from HSCIC show twice as many births generally in deprived areas compared to the least deprived, but for teenagers the difference was tenfold, with 31.1 per thousand in the most deprived areas but only 3.6 per thousand in the least deprived. 

Under-treatment of cancer amongst retirees is seen as a key reason why the UK performs worse than some other European countries. 

Cancer survival rates lag behind other European countries: 

New research suggests that 207,000 11-15 year olds start smoking in the UK each year. 

The work capability assessment disadvantages people with learning difficulties, mental health problems and autism according to a ruling from the court of appeal, upholding an early ruling which had been challenged by DWP.  Three charities called on the Government to stop using the ‘flawed assessment’.  The Government said the judgement would have ‘no effect on day-to-day business.’ 

38% of managers in health and social care are considered ineffective by their staff, according to a report from the Chartered Management Institute. 

23% of elderly people who had had an overnight hospital stay said they felt very vulnerable on returning home, according to a report by RVS, which also reports on its scheme in Leicestershire to support people leaving hospital and reduce readmissions. 

Survey of CCGs shows generally good relationships with NHS England.

4th December 2013

Young workers have been particularly hard hit by the recession according to a report from the Resolution Foundation which found that 22-29 year olds’ hourly pay had fallen by 11.7% in the three years following 2008 compared to a fall of 8.1% for all workers. 

Young people are to be allowed to stay in foster care until they are 21.

Children and young people’s mental health is being overlooked by local authorities according to a report by the Children and Young People’s Mental Health Coalition. 

Food poverty has reached the level of a public health emergency according to doctors and academics who have written to the BMJ, noting that a Government report has been delayed. 

(5th December) What councils can do about the food poverty crisis: 

Kent Leader withdraws county council report linking food poverty to the welfare system. 

Older people are suffering more alcohol related health problems with alcohol related hospital admissions amongst those in their 60s having tripled in a decade: described by the Telegraph as baby boomers suffering the effects of more liberal attitudes to alcohol. 

The 1,000 or so Health Trainers in England are improving health and reducing health inequalities according to a report from the Royal Society of Public Health. 

3rd December 2013

The numbers using A&E have risen by 11% in 4 years according to ‘Focus on Accident and Emergency December 2013’ published by HSIC.  Charities blamed cuts to social care.  The BMA blamed NHS111.  Labour said the Government were ignoring the problem.  The Government blamed increased demand from an ageing society and Labour’s 2004 change to the GPs’ contract. 

Half of A&E attendees only needed advice at most: 

April-June is the busiest time, not winter, and more young people than over 70’s use A&E:–not-winter-reveals-report-8981083.html 

Small but significant shift in older people going to A&E:

The NAO says troubled families programmes are underperforming because of poor co-ordination between DWP and DCLG. 

Social workers do not have the capacity to concentrate on safeguarding vulnerable young people according to a report by the British Association of Social Workers for the All Party Parliamentary Committee on Social Work. 

The report (pdf): 

(5th December)

Self-employed workers have seen their incomes drop dramatically with incomes for those earning between £2k-£100k have dropped by 31% in the last twelve years. 

2nd December 2013

Disabled people are being given false hope that the ‘spare bedroom benefit cuts’ do not apply to them, according to 18 Charities who have written to the Prime Minister after he said “what we have done is to exempt disabled people who need a spare room” which they say does not “reflect the reality of the Government’s policy.”

Towards Whole Person Care published by IPPR, recommending single point of contact for all care needs; access to peer support; online access to personal health and care records; personal care plan; the option of a personal budget. 

Just over 200 people a year are dying of malnutrition or dehydration while in a hospital or care home according to figures published by ONS. 

Issues to be covered in local Healthwatch annual reports is set out in new directions. 

NHS News: Issue 35 

1st December 2013

Andy Burnham, calls for a series of patient rights to be added to the NHS Constitution including to have a single health and care co-ordinator; patients owning the care records which would be accessible online; a personalised care plan; access to peer support.  He was responding to an IPPR report (2nd December). 

29th November 2013

A survey by Tesco found that a quarter of people struggled to buy as much healthy and nutritious food as they did a year ago while the Trussell Trust says foodbank usage has tripled over the last year as a Christmas charity food drive starts which is said to be the largest since the second world war. 

[Weekly update sent out ————————————————————–]

29th November 2013

All specialist mental healthcare services are to be inspected by 2015 

GPs are urged to refer elderly patients with anxiety or depression to talking therapies after a survey showed that only 6% of service users were over 65s, despite the group constituting about 21% of the population with such problems. 

Half of dementia sufferers are not formally diagnosed, with wide variations round the country, according to a Government report. 

28th November 2013

Councils may have to cut many discretionary services, such as libraries, arts and playgrounds, completely because of funding cuts over the next few years according to a JRF report.  It says that spending power has been cut by £100 per head more in northern and midland councils than in more affluent areas, with cuts bigger in Labour than Tory or Lib-Dem areas.  Another report by the Audit Commission warns that one in ten councils are at risk of going bust.  It also notes that poorer areas have shouldered a larger proportion of cuts.

Sir Merrick Cockell says the local government funding system is broken: 

Government accuses councils of “amassing secret stockpiles” of financial reserves. 

54% of those who had tried to access counselling and talking therapies had to wait more than three months and 12% had to wait more than a year, according to a survey of 1,600 people by Mind.  The ‘We Need to Talk’ coalition of mental health groups in England says people should have access to help within 28 days.

The Government is to commission an independent review into cigarette packaging in England.  The review is to be led by paediatrician Sir Cyril Chantler.  The Government put off a decision on plain packaging in July, saying it wanted to wait for evidence of the Australian experience.

Latest Friends and Families test results are published 

NHS England is to set up a patient feedback website allowing patients to post comments and for hospitals to respond.  [This will presumably replace the current NHS Choices website which offers a similar facility.  Patient Opinion, a social enterprise also performs a similar function.] 

28% of admissions to hospital for heart disease involve diabetes patients, and patients with diabetes are 38% more likely to die prematurely, according to figures from HSIC. 

NHS England sets out its assurance process for CCGs and its own direct commissioning functions 

Bulletin for CCGs: Issue 47 

27th November 2013

Councils in the North East will lose £665 per person compared to £305 in the South East, on average from cuts to local government spending by 2017-18 according to analysis by SIGOMA, the LGA special interest group of municipal authorities.  The Government said that northern councils had more spending power per household than southern ones. 

NHS England appeals for ‘winter friends’ asking people to sign an electronic pledge to say they will look out for an elderly friend or neighbour this winter.

NICE is proposing to ban patients from smoking outside hospitals and NHS staff from smoking at all at work or while in uniform. 

The financial cost of cancer to sufferers averages £700 in the first year alone according to a report from Demos.–the-average-mortgage.html

The National Association of Primary Care is to join the NHS Confederation as its primary care provider network. 

NHS News: Issue 34

25th November 2013

NHS England is to call on commissioners to reduce the mortality gap for people with mental health issues which means their life expectancy is ten years less than the rest of population. 

A DH programme aiming to provide telehealth to 100,000 people in seven pilot areas called ‘3million lives’ has changed to one which aims to work with areas where there is already ‘energy’ for it, to reach 3 million people by 2017, since the programme was taken over by NHS England in April.

(Free subscription)

A new free phone line has been set up to help combat loneliness in older people.  The ‘Sliver Line’ service is chaired by Esther Rantzen and offers friendship, information and advice from volunteers.  The number is 0800 4 70 80 90. 

Data on progress of the troubled families programme 

(Press release) 

Widespread use of the NHS number to identify people is key to integration of health and social care according to NHS Director of Patients and Information, Tim Kelsey. 

PHE Bulletin

23rd November 2013

Bed blocking in October was the highest since August 2010 when the monthly figures were first published.  There were 78,424 hospital bed days lost through delayed discharges in October, up almost 8,000 on the same month last year. 

22nd November 2013

A £75m Big Lottery programme will help tackle child mental health issues as schools in twelve areas will provide resilience lessons to 10-14 year olds. 

The NHS Alliance has developed a nine-question version of the friends and families test for GPs which it hopes will be widely adopted (there is a requirement only to ask one mandated question and one locally chosen one). 

Morrisons is the first supermarket change to ban the sale of high caffeine drinks to children under 16. 

[Weekly update sent out ————————————————————–]

21st November 2013

The CQC says hospitals have made no improvement in patient safety, treating patients with dignity and respect or monitoring and assessing the quality of care over the last year despite a number of reports following the Mid-Staffordshire scandal, according to its annual ‘State of Care’ review. 

More elderly people are being admitted as emergencies for preventable conditions, the report says: 

Half a million avoidable admissions: 

Nursing homes still the worst performing social sector:

An OECD study finds Britain’s cancer survival rates are unacceptable, when compared with other developed countries.  Matching the average survival rates across European countries would save 10,000 lives a year.

Volunteers play an important role in hospitals with 500 in the average trust, creating £11 in value for every £1 invested in them, according to study by the King’s Fund. 

A strategy on liver disease promised two years ago has still not appeared, says charity the British Liver Trust, while deaths from liver disease are increasing, the only major cause of death for which that is the case. 

Electronic prescribing in NHS hospitals is patchy, with 69% of 101 surveyed hospitals using some form of electronic prescribing but with wide variety in the systems used, according to research published in Plos One. 

20th November 2013

An additional £150m for A&E’s is to be provided from an NHS England underspend, adding to the £250m announced in September.  The £250m was for just 53 hospital trusts, but others will be able to apply for the new money. 

Long term increases in personal debt, with the average per household having risen to £54k from £29k a decade ago, is having a severe effect on mental health and wellbeing according to ‘Maxed Out’, a report from the Centre for Social Justice, the think tank that Iain Duncan Smith helped set up.  The report also notes that consumer debt has trebled since 1993. 

Children’s basic human rights are being denied by government cuts and reforms, according to a report, ‘The State of Children’s Rights’ from the Children’s Rights Alliance for England, a group of 60 charities. Many more children are living in poverty, and inequalities of health and education continue, it says.–report-8950143.html 

Children’s fitness has been gradually decreasing by about 5% a decade when measured in terms of how far children can run in a set time, according to Australian led research based on data on 25 million children in 28 countries over 46 years.

The use of anti-depressants in rich countries has risen over the last decade, not matched by increases in diagnoses of depression, according to the OECD in a report ‘Health at a Glance.’ 

(21st November) 

OECD ‘Health at a Glance’ 

(19th November) the position in Scotland: 

Five fundamental ‘disconnects’ between policy and practice have been identified in research initiated by the Institute for Government and the Big Lottery, which paired 15 civil servants with15 people from the voluntary sector. 

Sir Bruce Keogh rescues Cyberman.  [Doesn’t he know they’re the bad guys?] 

19th November 2013

In the Government’s response to the Francis enquiry, Jeremy Hunt announces a series of measures to increase safety.  They include a requirement to publish ward staffing levels, a legal duty of candour to be honest about mistakes that cause death or serious harm, a criminal offence of wilful neglect and a quarterly report by hospitals on how they are handling complaints. 

NHS Confederation response: 

Response from Nicholas Timmins on Institute for Government blog: 

What NHS England is already doing in response to the Francis report:

New guidance on staffing levels for nursing, midwifery and care are published by the National Quality Board. 

‘Challenging Bureaucracy’ report from the NHS Confederation. 

What private health providers think of the NHS and privatisation.  Results of a survey of 110 industry leaders by HealthInvestor magazine.

The UK Council for Psychotherapy’s voluntary register has been accredited by the Professional Standards Authority for Health and Social Care. 

18th November 2013

21 Trusts could be putting patients at risk by performing vascular surgery when they do not do enough operations to have the necessary expertise according to Dr Foster. 

[Weekly update sent out ————————————————————–]

16th November 2013

Doctors, nurses and NHS managers could face criminal prosecution for wilful neglect or mistreatment of patients, with the possibility of five years in jail, under a proposed change to the law to be announced by Jeremy Hunt. 

15th November 2013

The Government agrees a new contract with GPs including changing conditions introduced last year that it is argued caused more red tape.  Patients over 75 and those with long term health needs are to have a named GP.

King’s Fund comment:

New rules allowing the testing of European doctors’ language skills, as well as other safety measures for nurses and health professionals, have been agreed by EU ministers.

NHS England urges people with existing conditions to seek help early rather than going to A&E. 

Children, Families and Maternity e-bulletin, November

14th November 2013

50,000 disabled people could lose their jobs if changes to their support from the Disability Living Allowance (DLA) go ahead, according to the Disability Benefits Consortium, a national coalition of over 50 charities. 

NHS News: Issue 33

Bulletin for CCGs: Issue 46 

13th November 2013

Keogh Review on urgent and emergency care published.  It recommends keeping all 140 A&Es but concentrating expertise in about 40-70 of them.  There are also proposals for reducing the number of people taken to A&E. 

Sir Bruce Keogh explains the changes:–just-sticking-plaster-Two-tier-casualty-units-speed-care-111-service-gets-doctors-shake-health-care.html

A revamp of NHS 111 will mean call handlers having access to patient records and more clinical support. 

An evaluation of NHS 111 pilots found they increased the number of emergency ambulance incidents by just under 3%, but NHS England said things had changed since NHS 111 was introduced and that attendances in areas with 111 had decreased by 0.2% compared to the previous 12 months. 

More than 522,000 housing benefit claimants were subject to the bedroom tax in August, with benefits reduced by £14.50 a week, according to figures from DWP.

Funding for maternity care has been cut in half of English regions despite a record high birth rate, according to figures obtained by a Lib-Dem MP in a parliamentary question. 

New Government scheme to encourage people to use the stairs in public offices by labelling the number of calories used.  A new app, ‘StepJockey’ is backed by DH and funded by the Small Business Research Initiative. 

Briefing from PHE on obesity and the environment, increasing physical activity and active travel. 

NHS News: Issue 32

12th November 2013

David Cameron defends a smaller state, rather than cutting just to reduce the deficit. 

Four big outsourcing firms were paid £4bn last year for public service contracts according to an NAO report commissioned by the Public Accounts Committee.  The four groups made £1.05bn profit worldwide last year but paid between £75m and £81m in UK corporation tax. 

Young people in care do not get all the support they are legally entitled to and many are not aware of their rights according to a report by The Who Cares Trust, on behalf of the All Party Parliamentary Group for Looked After Children and Care Leavers. 

There is a shortage of 20,000 nurses according to the RCN, based on foi responses received from 61 of the 162 trusts.  The NHS Confederation is reported as noting the context of 347,000 qualified nurses in the NHS with 10,000 recruited every month through natural turnover. 

A revised NHS mandate is published by the Government.

The NHS Confederation welcomes requirements having been taken out of an earlier consultation draft: 

NHS England response: 

Michael Gove says he wants to radically reform social work, taking the dogma out of training. 

Article suggesting the main problem for social workers is lack of time and resources: 

Interview with Maureen Baker who takes over from Clare Gerada as Chair of the Royal College of General Practitioners on Saturday 16th November.  She would like to make it easier for GPs who have left the NHS (such as to have children) to return. 

An experiment will offer new mothers up to £200 in shopping vouchers to encourage them to breastfeed their babies for at least six months.  The pilot is targeting areas of South Yorkshire and Derbyshire and is being funded through a collaboration between the government and medical research sector.

Only 35% of people would tell their employer if they had schizophrenia according to a YouGov poll of more than 2,000 people, for the charity Rethink Mental Illness, suggesting a continuing stigma about admitting mental illness. 

The problem of the ageing population is not as great as has been claimed, according to analysis by Edinburgh academics published in the BMJ.  Noting that elderly people may be healthy and working age people may be dependent, they calculate an alternative ratio of the number of people in their last 15 years of life divided by the number of people of any age in employment, which they say has been improving over the last four decades. 

Depression increases the ageing process in cells (reducing telomere length) length according to Dutch research on more than 2,000 people.  Depression is already known to increase premature mortality, but this is partly down to behavioural issues such as drug and alcohol use and inactivity.  However another expert is reported as saying only severe depression affects telomere length which anyway doesn’t consistently predict risk of death. 

The new CE of the NHS Confederation is to be Rob Webster, replacing Mike Farrar. 

The NHS Outcomes Framework for 2014-15. 

Annual update to Public Health Outcomes Framework

11th November 2013

53 of 238 Walk in Centres have closed over the last three years, leaving 185, according to Monitor, warning that the centres are popular with patients whose needs should be fully considered.  Some patients are already registered with GPs meaning the CCG is effectively paying twice.  [By way of context, there are about 8,000 GP practices in England.  There is a map showing the location of the centres on p.22 of Monitor’s document.] 

A comparison website for adult social care has been launched by the Government.  It uses 21 indicators from the Adult Social Care Outcomes Framework, already published by HSCIC, but makes them more accessible to the public, allowing comparisons between areas. 

Adult Social Care Outcomes Framework

10th November 2013

52 out of 152 Directors of Children’s Services left their position in the twelve months to July 2013 according to the Independent on Sunday.  Thirteen authorities have had four directors in the last five years.  Only 25 authorities have had the same DCS since 2008. 

8th November 2013

A third of hospitals could face major financial difficulties in the next few months, with the numbers involved larger than the system is currently designed to address, according to the Nuffield Trust.  The DH is quoted as saying “The NHS is in good financial health.” 

After losing an Appeal Court ruling, the DWP has said it will reconsider the abolition of the Independent Living Fund.  The judges said the Government had not properly complied with the public sector equality duty to assess the effects of the closure of the scheme. 

Charges on temporary visitors for use of the NHS should not be applied to vulnerable people such as refugees and victims of trafficking, the Home Affairs Select Committee has told the Government. 

Survey on public involvement in the appraisal and governance of doctors. The survey is aimed at those involved in patient and public involvement and closes on 22 November. 

[Weekly update sent out ————————————————————–]

8th November 2013

Maternity units are increasingly overstretched with a shortage of 2,300 midwives and the highest level of births for 40 years according to a report from the NAO. 

The NHS spends £700 insurance cover for every birth:

54% of people agree it is fair that people of working age who live in social housing should receive less housing benefit if they have more bedrooms than they need according to research by Ipsos MORI.  When given more information, 44% supported and 31% opposed the 14% benefit reduction for an additional bedroom. 

The Government has said it will review food standards in hospitals after evidence that one in three elderly patients who need help to eat, do not receive it. 

Infographic from ONS on the health gap between demographic groups.–wales–english-regions-and-local-authorities–2011/info-health-gap.html

7th November 2013

Middle aged men are more likely to be fat but to do nothing about it, according to research on 10,000 people born in 1970. 

6th November 2013

The NHS is 600 consultants short of the 2,000 needed for A&E care that is available 16 hours a day, according to the College of Emergency Medicine. 

Back pain, followed by depression are the biggest causes of disability worldwide, according to Australian research. 

(8th October) 

The pharmaceutical industry has agreed to cap drug costs at £12bn over the next two years and pay any extra costs itself.

Report, “icare: Information, Communication and Technology in the NHS” published by the Academy of Medical Royal Colleges with seven key recommendations on patient records and other data.

5th November 2013

Pressure on A&E departments is to be eased by moving staff to seven day a week working and transferring treatments to the private sector according to Prof Sir Bruce Keogh, National Medical Director of NHS England. 

Britain’s happiness levels rose by 1% between 2007 and 2011 putting it in the top 20% of countries, while those countries badly hit by the recession saw falls in happiness levels according to the OECD. 

90% of GPs think patients would benefit from social prescriptions but only 9% of the public have received them, according to survey results published by Nesta and the Innovation Unit.

Hospital admissions have risen by nearly 13% in five years according to figures from the HSIC.—up-nearly-13-per-cent-in-five-years 

Quarterly update of Public Health Outcomes Framework indicators published. 


4th November 2013

A quarter of doctors registered with the GMC were trained outside of Europe saving the NHS billions of pounds according to a report by Health Poverty Action.

(1st November) 

Any future attempts to reverse increased private sector involvement in health could be prevented, alongside other reforms, as a result of the Transatlantic Trade and Investment Partnership which allows disputes between corporations and governments to be resolved by panels of corporate lawyers which do not meet in public. 

We are buying fewer calories but less healthy foods and doing less exercise according to two studies of Britain’s food expenditure published by the Institute for Fiscal Studies. 

But it is suggested the findings may reflect people under-reporting the food they have eaten: 

Those suffering from cancer in well off areas are a third more likely to survive than those in poorer areas according to analysis of NHS figures by Macmillan Cancer Support and the National Cancer Intelligence Network. 

More people died at home or care homes than in hospital than four years ago, reflecting people’s wish to die at home.

Ofsted toughens the rules on inspection of pre-schools, in line with changes already made for schools and colleges. 

3rd November 2013

It is reported that the NHS has approached private equity companies about taking over commissioning support units.

1.96 million children lived in families where the parents or guardians earned less than the living wage last year, an increase of 8% from 1.82m the previous year, according to research by the Children’s Society. 

2nd November 2013

Research has suggested that more poorer women are dying from breast cancer than others, with 450 such deaths a year associated with poverty.

Senior A&E doctors warn that a crisis is brewing this year in emergency care, with a rise of 43% in the numbers waiting more than 4 hours compared with two years ago.

1st November 2013

Fourteen ‘Integration Pioneers’ have been announced, which will pilot collaborative working between health and social care.  The areas will receive support but no additional funding.  The 14 areas are: Barnsley; Cheshire; Cornwall and the Isles of Scilly; Greenwich; Islington; Leeds; Kent; North West London; North Staffordshire; South Devon and Torbay; Southend; South Tyneside; Waltham Forest and East London and City; Worcestershire.–2 

House of Commons briefing note on the reformed health system in England

31st October 2013

Labour promises a right to counselling for mental health problems in the NHS constitution.  The Government has not commissioned a 2012-13 national survey of spending on adult mental health and figures for such spending are no longer available. 

The NAO says there are too many urgent admissions to hospitals in England, noting that the numbers have been steadily rising and a higher proportion of those attending are being admitted to hospital.  They estimate that a fifth of those admitted could be dealt with outside hospital.

Friends and Family test results for September are published. 

Blog: four ideas for how social action and co-production could reduce the pressure on A&E:

Review of Health and Wellbeing Boards, one year on by the King’s Fund: ‘Side Show or System Leader?’ 

Publication of data on the performance of medical consultants is to be extended to 10 more areas and is to include feedback from patients. 

The health risks from fracking are low as long as operations are well run according to PHE, such as ensuring cracks in the well wall do not lead to water contamination.  However the report looked only at the risks of direct emission of chemical and radioactive materials, not issues such as noise, odours, sustainable water use or climate change. 

NHS News: Issue 31 

The Quarter: Q4 2012-13 – quarterly NHS performance information. 

30th October 2013

The 1 million plus NEETs in this country are a ‘public health time bomb waiting to explode’ according to a WHO report.  The health impacts are likely to be felt in 10-20 years time.

Interactive map:

Elderly and disabled people are unhappy with the homecare they receive, with 39% saying the local authority assessment and organisation of care was poor or very poor, with 17% saying it was good or very good, according to a DH and Guardian survey of 1440 people. 

Detailed results:

The implementation of ‘Payment by Results’ has been seriously flawed with contracts often not recognising the complexity of the situation and introduced as the ‘political flavour of the month’ rather than as part of a coherent strategy, according to a review for the NCVO. 

More than half of English CCGs are considering longer GP opening hours, with a quarter actively planning them, according to foi responses from 129 CCGs obtained by Pulse. 

Ofsted publishes response to consultation on inspection of children’s services. 

The number of people trying to quite smoking through the NHS by setting a ‘quit date’ has fallen by 11% from 816,000 to 724,000 according to data from the Health and Social Care Information Centre.  However smoking rates are at their lowest, at 19.5%. 

Statistics on workplace accidents, deaths and work related illness from the Health and Safety Executive.  There is long term improvement in the figures, with Britain being the third best in Europe, but there are still 13,000 work related deaths each year (many due to previous problems) with an annual social cost of £13.8bn.

The final Remploy factories, providing sheltered employment for disabled, people are closed, with the end of government subsidy. 

Annual reporting of use of the Mental Health Act 2003 from HSCIC. 

29th October 2013

The Court of Appeal rules that Jeremy Hunt did not have the power to implement cuts at Lewisham Hospital, confirming an earlier judgement.  However amendments being made to the Care Bill will provide those powers in future. 

Just over half (53%) of children in poor families said their homes were too cold last year, according to a survey of 2,000 10-17 year olds published by The Children’s Society.  The Society is setting up The Children’s Commission on Poverty to explore the issue further.

Government launches strategy on young people leaving care. 

Increasing numbers are using children’s centres with two thirds of disadvantaged families using them, but budgets have been cut in 66% of them, according to a census by 4Children. 

(Free subscription) 

Active hobbies such as gardening cut the risk of death among older people by 30% according to a Swedish study of nearly 4,000 sixty year olds over twelve years.–Active-hobbies-reduce-chance-heart-attack-stroke.html 

Well designed exercise programmes can reduce falls, according to a review by French researchers published in the BMJ and covering 17 studies with a total of 2195 participants. 

The Shape of Training Review recommends that training should equip doctors to provide general care in broad speciality areas across a range of settings in order to adapt to the changing healthcare landscape. 

NHS Confederation response:

Obesity and Social Care: discussion paper from the LGA. 

28th October 2013

Ann Clwyd’s review of the NHS complaints system has reported, with twelve key organisations having pledged to make improvements.

Jeremy Hunt criticises the size of senior NHS manager salaries. 

Nearly three quarters of cancer patients who die in hospital would have preferred to die at home according to estimates by Macmillan Cancer Support which has issued a report with recommendations for improved end of life care including making social care free for everyone in their last few weeks of life.,000cancerpatientsdeniedtheirlastwishtodieathome.aspx

27th October 2013

The BMA is welcoming full seven days a week access to the NHS in an apparent reversal of their previous position. 

26th October 2013

Food companies pledge to reduce the proportion of saturated fat in their products as part of the ‘responsibility deal’ but Prof John Ashton, president of the Faculty of Public Health calls it a drop in the ocean and says the approach lacks credibility. 

25th October 2013

The introduction of PIP (Personal Independence Payments) is being delayed, to be rolled out gradually across the country, as the claiming process is taking longer than expected.  The change from the DLA (Disability Living Allowance) has been widely criticised as being more restrictive (e.g. tightening the distance you can walk from 50m to 20m) and creating more uncertainty. The change was announced in a written statement to Parliament.

(21st October) 

(29th October, Analysis and comment, Polly Toynbee): 

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25th October 2013

Spreadsheet organogram of DH senior posts.

24th October 2013

Simon Stevens is to take over from Sir David Nicholson as Chief Executive of NHS England.  Stevens is a senior executive in US health firm United Healthcare, a former adviser to Labour and sometime NHS manager.

A quarter of hospitals in England are at risk of providing poor care according to a CQC review of statistical data, part of a screening process for its inspection programme.

Staff from 74% of hospitals (119 of the 161 acute trusts) have privately raised concerns about patient safety with the CQC.

A report on ‘Co-ordinated Care for People with Complex Chronic Conditions’ is published by the King’s Fund, drawing the lessons from five UK based programmes.

NHS Direct in England is to be closed down next year.  (The NHS Group in Wales will continue).

England chief medical officer, Prof Dame Sally Davies, has said in her annual report that all children under five should be offered vitamin supplements.  There are claims that 25% of children are vitamin D deficient which has led to a rise in rickets.

Children with long term conditions should have a named GP co-ordinating their care: 

Failure of the existing scheme to provide vitamins:

The IAPT talking therapies programme is struggling to meet its targets with long waiting times in many areas.

23rd October 2013

Northern Ireland is the happiest place in the UK, and personal wellbeing generally in the UK improved slightly between 2011-12 and 2012-13 according to new data from the ONS.–2012-13/sb—personal-well-being-across-the-uk–2012-13.html

DCLG analysis:

Deaths from heart disease and strokes halved between 2001 and 2012 but the numbers dying from cancer rose and now outnumber those from circulatory disease according to new data from ONS. 

However, another report says that the incidence of strokes is increasing amongst younger people globally and is higher in poorer areas: (24th October)

Diagram showing mortality so far in the 21st century: 

NICE produces guidance on reducing obesity in children.  It includes recommending children keep a record of the time in front of tv and computer screens as part of becoming more active.  Family support is critical. 

The benefit cap is failing to save money or force unemployed people to get a job according to research in Haringey by the Chartered Institute of Housing. 

The Government criticises the study but has no evidence of its own: 

Map showing how the benefit cap restricts where people can afford to live in London: 

The new GP role as named clinician proactively caring for elderly people is likely to be written into new GP contracts next year according to a speech given by Jeremy Hunt. 

The Government should be doing more to support community budgets, according to a report from the House of Commons Community and Local Government Committee. 

Essex Leader says they have not received enough support from Government departments:

22nd October 2013

People from overseas cost the NHS between £1.5bn-1.9bn a year, of which £500m could be recovered according to research for the Government.  The Government says it intends to set up a new unit to collect the money owed by foreign governments as well as charging a £200 levy on migrants from outside the European Economic Area staying for between six months and five years. 

‘Reality check’: 

NHS Confederation response, expressing concern and arguing for a more targeted approach to the issue: 

The Refugee Council response says the plans will be counterproductive, costly and increase health inequalities:

Money makes a difference to children’s outcomes according to a review of research which found that children in low income households tend to have poorer outcomes, such as in education and health.  The research was undertaken by the LSE for JRF. 

HMRC is said to be investigating 120 care companies who may be finding ways round paying the minimum wage. 

NHS England is to approve fewer than the current number of Commissioning Support Units (CSUs) under a new framework agreement, expected to be finalised by 2015. 

SCIE with TLAP have launched a guide to co-production. 

21st October 2013

The Government is accused of a u-turn on 15 minute care visits as a result of its proposals to limit the power of the CQC to review commissioners’ decisions.  The Government’s amendments to the Care Bill would mean that the CQC could only comment on the quality of care not the commissioning that produces it. 

David Behan (CQC CE) says the debate on this isn’t over: 

(22nd October) Government response: 

The Government has rejected the majority public response on its proposals for mobility support for disabled people. It is sticking to the reduction from 50m to 20m the distance you need to be able to walk to get support under the new PIP (Personal Independence Payment) arrangements.  914 out of 1142 responses disagreed with the government’s position and no organisation’s supported the Government’s proposals.

Blog with detailed explanation:

The Government’s official response: 

(22nd October)

Schools are to be given a legal duty to support children with long-term health conditions such as diabetes, epilepsy and asthma, the Government has said.  The duty is to be introduced through an amendment to the Children and Families Bill.

A number of publicly funded care companies are avoiding tax by paying back loans to parent companies according to research by the Independent. 

NHS News: Issue 29

20th October 2013

Jeremy Hunt says hospitals have to respond to all complaints, after it was found that some were refusing to respond if complaints were taking legal action or even just exploring it. 

(21st October) 

18th October 2013

Doctors says plans for GP surgeries to open 8am to 8pm seven days a week are unachievable because of the extra number of doctors and extra funding required.  A survey finds that currently 15% of surgeries open for at least part of Saturday. 

Government announces new innovation programme for Children’s Services. 

[Weekly update sent out ————————————————————–]

18th October 2013

The gap between rich and poor is causing thousands of unnecessary deaths according to NHS Scotland. 

Bulletin for CCGS: Issue 44 

17th October 2013

The Competition Commission has intervened in the NHS for the first time, blocking the merger of two Foundation Trusts on the grounds that it would damage patients’ interests by eliminating competition and choice.  The Commission intervened, following a referral from the Office of Fair Trading, on the basis that the Trusts are independent hospitals and can be treated as ‘enterprises’ under European law. 

The NHS Confederation says the decision is a body blow for change in the NHS:

The King’s Fund response notes that the Government promised that Monitor rather than competition bodies would play the biggest role in health regulation:

King’s Fund blog on the case: 

An amendment to the Care Bill would enhance the Government’s powers to authorise the closure of wards and hospitals. 

The working poor are bearing the brunt of the cuts according to the Government’s Commission on Social Mobility chaired by Alan Milburn, and a redistribution from older to younger may be necessary to increase social mobility. 

(16th October) 

WHO has classified air pollution as a leading environmental cause of cancer for the first time. 

CQC response to public consultation on how it regulates and inspects care services 

The Government is to order a review into 15 minute care visits.

The EU has ruled that food manufacturers can make a health claim if sufficient fructose is used in them, although obesity experts say it can lead to weight gain. 

Rumination, or dwelling on negative thoughts is an even bigger contributor to stress and mental ill health than previously thought, according to a study by the BBC and Liverpool University based on a study of over 32,000 people. 

NICE provides guidance on treating obesity and suggests health staff should use non-blaming language. 

Nuffield Trust publication: ‘Managing financial difficulties in health economies: lessons for Clinical Commissioning Groups’.  Looks at why, in the past, some areas have been able to balance the books while others haven’t. 

16th October 2013

There has been a reduction in mental health beds of 9% or 1,711 bed closures, according to information from foi requests obtained from 46 of the 58 mental health trusts in England, by BBC News and Community Care Magazine.  The Care Minister, Norman Lamb said the situation was unacceptable and must improve. 

The Trussell Trust reports a tripling of food bank use in a year and has called on the Government to set up an official enquiry into the causes of food poverty.  The charity said that the increase was driven by benefit delays, welfare reform and low pay.  Oxfam has started to invest money in the Trussell Trust food banks.  The DWP said there was no robust evidence that welfare reforms are linked to the increase use of food banks. 

The Fabian Society’s ‘2030 Vision’ report makes recommendations for public spending for the Government elected in 2015 and makes proposals for accountability and better decision making on public spending. 

An evaluation of the Welsh Government’s ‘Flying Start’ programme, which helps children in the most deprived areas of the country, shows a positive response from parents. 

The number of complaints against doctors doubled in five years and increased by 24% between 2011 and 2012 according to figures from the GMC.  The 8,100 complaints in 2012 was still small compared to the number of doctors, 250,000. 

Patients unsure how to raise concerns about poor medical care:

NHS England and HSCIC are launching a £2m public information campaign about, a programme to make medical records more widely available to improve care.

Dementia self-assessment framework is published by DH.  Created by nurses and care staff, it allows comparisons to be made between current care and best practice criteria. 

NHS News: Issue 28 

15th October 2013

A new health funding formula is likely to increase the resources difference between north and south according to researchers from Durham University.  The formula reduces the weight given to health inequalities in favour of age as a factor.

The new approach to care home monitoring has been described by Andrea Sutcliffe the new Chief Inspector of Adult Social Care.  It includes involving ordinary people with experience of the care sector to help in inspections, and the possible use of hidden cameras. 

(14th October)

A Government review of regulation of adult social care found examples of duplication between the CQC and the local authority commissioners of care. 

20 out of 152 councils have unacceptably poor child protection according to Ofsted in its first standalone social care annual report.  Strong and sustained leadership is needed to bring about improvement, it says.

The Labour Peer, Lord Lipsey, has accused the Government of a u-turn on funding old age care, as only people with assets of less than £23k would not have to pay towards their care.

The key facts: 

The Prime Minister says there may be some flexibility in the £23k figure, which is just a starting point for consultation:

NHS England would consider lettering CCGs commission primary care if conflicts of interest could be overcome, according to the Chair of NHSE. 

The £50m innovations commissioning fund designed to progress treatments for rare diseases has been withdrawn by NHS England, having been announced only two months ago. 

Air pollution is associated with lower birth weight according to a European study.  Lower birth weight tends to lead to worse health.  The study controlled for other factors which an influence birth weight. 

And up to 96% of Europe’s urban population is exposed to fine particulate matter in concentrations above WHO guidelines, according to the European Environment Agency.

Guidance on roles, responsibilities and appointments of Directors of Public Health. 

An interactive map of PROMs (Patient Reported Outcome Measures) scores is published by HSIC, showing how patients valued the outcomes from 4 common surgeries from different providers. 

Report on health inequalities of those in contact with the criminal justice system by the ‘Revolving Door Agency’.–blog/news/balancingact/ 

14th October 2013

A third of hospital trusts are recruiting nurses from abroad because of an increasing shortage of nurses, according to foi requests from 105 trusts by the Nursing Times. 

LGA Publication: ‘Changing Behaviours in Public Health – to nudge or to shove’ 

13th October 2013

37% of young people with cancer are diagnosed following a visit to A&E compared with 13% for adults according to research from the teenage cancer trust. 

[Weekly update sent out ————————————————————–]

11th October 2013

An enquiry into doctors’ 48 hour a week limit arising from the European Working Time Directive has been ordered by Jeremy Hunt.  The Enquiry by senior doctors and NHS leaders is to be chaired by Prof Norman Williams, a critic of the directive. 

Sir David Nicholson has written to commissioners setting out some of the challenges facing the NHS. 

Suggestions that the Government might cut financial support for energy efficiency in poor households have been criticised by the chair of the Government’s Fuel Poverty Advisory Group. 

Vince Cable says removing green taxes would be ‘short sighted and foolish’. 

Smoking is even worse for you than previously thought according to an Australian study with two thirds of deaths associated with it rather than the half estimated by previous studies.  It is estimated to reduce life expectancy by 10 years. 

10th October 2013

There have been improvements in cancer treatment but more needs to be done according to the fourth annual national peer review report on Cancer Services 2012/13. 

Monitor says new ways are needed to meet the NHS funding gap, including learning from abroad.  A new report, ‘Closing the NHS Funding Gap: how to get better value health care for patients’ says that existing methods will not generate the £30bn savings needed by 2021.

An enquiry into how to have more employee participation and control in the NHS is to be led by Chris Ham of the King’s Foundation and will include Julian le Grand and Andrew Foster.

Satisfaction with the NHS remains high according to an ongoing survey by Ipsos-MORI for DH conducted last December but just published, with 77% agreeing that their local health service provides a good service, but 66% saying the NHS provides a good service nationally.  Only 27% agreed that the Government has the right policies for the NHS [not one of the details picked out in the Government press release].

Treatment of hip fractures has generally improved, but the proportion of readmissions within 28 days has increased by 41% in nine years and more needs to be done to reduce hip fractures, according to a report by the Nuffield Trust. 

The first annual QualityWatch report from the Nuffield Trust and Health Foundation:

The Government is to provide £500k funding for online mental health support for young people.  The grant is to MindFull, a children’s charity providing online advice, support and counselling to 11-17 year olds.  The grant will be used to expand the service to 18-25 year olds, improve the website and train thousands of new young peer mentors.  (The press release doesn’t say what period this covers).

The number of university students seeking counselling has increased by 33% in four years according to information from 114 universities provided to ‘Help Me’. 

The ‘responsibility deal’ for mental health has been expanded to include a pledge to promote wellbeing and resilience and to challenge stigma and discrimination.  Companies can sign up to the pledge committing to at least one of five statements, two of which are promoting wellbeing and tackling stigma.  56 employers are listed on the website as having signed up, including 28 public bodies. 

The number of people in Wales waiting more than 36 weeks for care has risen by more than 2,000 in a month, to 13,000 people. 

9th October 2013

Aircraft noise is associated with higher risks of stroke and heart disease according to research from Imperial College and King’s College London published in the BMJ.  What causes the association is not known but could be linked to stress or disturbed sleep. 

Patients and care users should become ‘savvy consumers’ and stand up for their rights, according to Healthwatch England’s (HWE) first annual report to Parliament.  A poll of 2,000 people found that a fifth of people had had poor service but only 54% (of that fifth) complained.  HWE set out a list of eight rights. 

Public Health England consults on draft knowledge strategy 

The percentage of patients free of four key harms rose from 91.7% in September 2012 to 93.1% a year later according to the NHS Safety Thermometer Report September 2012 – September 2013, published by HSCIC. 

National evaluation of dementia peer support networks and dementia advisers. 

18 local authorities are to receive £6.9m from the Transformation Challenge Award 

8th October 2013

94% of A&E doctors said they were working excessive hours, with six in ten saying their jobs were unsustainable in a survey of 1,000 UK consultants by the College of Emergency Medicine. 

NHS Confederation response: 

Cuts to social care funding are putting the human rights of older people at risk, as decent basic care cannot be afforded, according to a report from the Equality and Human Rights Commission.  Budgets are under pressure as a result of Government cuts to councils. 

The European Parliament has taken the first steps towards tightening anti-tobacco laws, in passing the first reading of a draft tobacco directive.  The directive would increase the size of health warnings on packs to 65% of each cigarette pack (currently 30% on one side and 40% on the other), would ban the sales of packs of 10 cigarettes and would ban the use of descriptions such as ‘mild’ or ‘low tar’. 

Poor children’s life chances are determined in primary school according to a report from Save the Children. 

Interesting video on inequality showing how most people think wealth is distributed much more evenly than it actually is (3 mins). 

And in the week of mental health day, the Sun’s contribution is headlined: ‘1,200 killed by mental health patients’. 

For the truth behind the figures see: 

7th October 2013

Two thirds of councils are commissioning 15 minute social care visits according to the Leonard Cheshire Foundation, based on foi requests.

ADASS President Sandie Keene calls the report misleading: 

All the reshuffle changes, from the Coalition and Labour 

Spending on children’s services is to fall by 2.73% before inflation next year with the biggest fall in children’s centres and early years, which are to fall by 14.8%. 

Early childhood experiences, including abuse or warm, loving relationships, can have a lifelong impact on health according to research by UCLA published in the Proceedings of the National Academy of Sciences 

The Welsh health minister has said the NHS should not be there to ‘pick up the pieces’ of people’s lifestyle choices.  He backed a Health Board which makes people with a BMI of more than 40 go on a health course before being added to the waiting list for elective surgery. 

Scotland has become the first country in Europe to prescribe a drug to reduce the craving for alcohol. 

A useful summary of health policy issues following the conference season, including: GP opening hours; hospital inspection; integration; the Care Bill; finance and funding; dementia; and A&E capacity.

NHS News: Issue 26

NHS News: Issue 27

6th October 2013

Average consumption of alcohol fell by 3.3% last year according to statistics from the British Beer and Pub Association 

Andy Burnham has instructed lawyers to write to Jeremy Hunt, seeking an apology for accusations that he attempted to cover up NHS failings when Health Secretary. 

(7th October) Hunt retracts cover up claims but maintains the attack: 

There is a financial case for bridging the gap between mental and physical health according to a report from the Centre for Mental Health. 

4th October 2013

Jeremy Hunt urges two pay review bodies to cancel a planned 1% pay increase in the NHS next year and to scrap annual increments.

House of Lords briefing paper on parity of esteem between physical and mental health. 

[Weekly update sent out ————————————————————–]

4th October 2013

The number of A&E units failing to meet the 4 hour target has nearly tripled from 14 to 29 in the last year. 

Walking can cut the risk of breast cancer for post-menopausal women, with those walking 7 hours a week having a 14% lower risk compared with those walking three hours or less, according to a study by the American Cancer Society following 73,000 women aged 50-74, over 17 years, with questionnaires on their health and activities completed every two years. 

3rd October 2013

Hospitals are expected to face a cut of £500m next year on top of the £1bn already expected, according to the Foundation Trust Network, which represents all 160 hospital trusts in England, after Monitor announced a 4% reduction in payment for operations. 

NHS Confederation response: 

Funding for GPs has fallen by 7% per patient or £400m in real terms over the last three years according to an analysis by the Royal College of GPs. 

The proportion of people who have volunteered in the last three months has increased from 21% in January to 26% now, taking it to the highest level in ten years, according to a survey of 1,000 people by the nfpSynergy consultancy. 

A CQC official has been cleared of a cover up over an internal report on the CQC’s investigation of a Cumbrian hospital.  Anna Jefferson, media manager was cleared in an internal inquiry.  The other two people named by the CQC (on 20th June), Cynthia Bower and Jill Finney, no longer work for the CQC so were not subject to an internal investigation. 

The Irish Health Minister has published a plan to reduce the number of smokers to less than 5% by 2025, with 60 recommendations.  The Irish Republic was the first state to ban smoking in the workplace in 2004. 

Bulletin for CCGs: Issue 43 

2nd October 2013

‘Building the House of Care’, which proposes a co-ordinated and patient centred service delivery model for people with long-term conditions, is published by the King’s Fund

A briefing on the Care Bill from Carers UK.

1st October 2013

Access to GPs from 8am-8pm, seven days a week is promised by the Prime Minister.  A £50m fund will be open to competitive bids, with more detail on this in December and the ‘pioneers’ to start in April 2014.  The press release says the new services will be available to ‘hard working people’.  It does not specify whether it will be available to others (maybe pensioners) who do not work hard.–seven-days-a-week-8849349.html 

The CQC is to be made independent of ministerial control, Jeremy Hunt has announced, with the Secretary of State no longer able to decide what should be inspected or how. 

The Friends and Families Test is to be extended across the NHS and to other public services including further education and Jobcentre Plus.  It is to be extended to all NHS services, including mental health, community nursing and outpatient appointments by April 2015. 

22,000 children and teenagers were treated in hospital for self-harming last year, an increase of 11% for those aged 10-19 and a 30% increase for those aged 10-14.  More teenage girls are treated for self-harm and more boys for assault according to the Health and Social Care Information Centre. 

78% of people taking out payday loans did so to buy food according to a survey by Christians Against Poverty. 

(Link to pdf) 

The Prime Minister’s preferred choice to be the next head of the NHS is said to be Simon Stevens, a former health advisor to Tony Blair who subsequently worked for UnitedHealth, a US not-for-profit healthcare provider. 

(2nd October) Background on the job and appointment process: 

Early literacy support can close the gap caused by poverty and has lasting effects according to a report from the Institute of Education. 

Sweden is the best country to grow old, according to a UN supported study, with the UK ranked 13th. 

Interactive map: 

‘Stoptober’, the NHS’s month long campaign to persuade people to stop smoking, has started. 

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