Health and Wellbeing Policy News 15th-24th July 2016

Here are some of the bigger items of health and wellbeing policy news collected in the last week.  A fuller list (in date order) is available here.

21 July 2016
A 'reset' of NHS finances will see trusts and CCGs in special measures and the ending of some fines for waiting times,  NHS England, NHS Improvement and the CQC have announced.  Five NHS trusts and nine CCGs are being put into special measures.  Nationally set fines for missing waiting time and other targets are being replaced by measures related to the improvement of individual organisations.  Trusts are to receive £1.8bn from a sustainability and transformation fund, to help bring their deficit down from £2.45bn last year to £250m this.  However, there are concerns that attempts to save money could affect patient care and safety, with trusts facing financial penalties for 'over-recruiting' staff.  It was also suggested that the problems are systemic rather than caused by poor management in individual organisations.
Attempts to cut staff will be met with stiff resistance:

19 July 2016
The Government has not fulfilled its claim to be funding the Five Year Forward View, the House of Commons health select committee has said.  Rather than giving health an extra £8.4bn a year by 2020, that figure only applies to NHS England, whereas the complete health budget, including such things as education, public health and other DH funding, will only rise by £4.5bn.  That bigger budget has been the normally accepted definition of NHS spending up until now.  Taking money out of those other areas will make it harder to achieve the ambitions of the Five Year Forward View.  A proportion of the extra money will also have to go towards paying off existing deficits. The committee also says that measures such as holding down pay and capping agency staff are not sustainable ways of finding the £22bn savings required.  Seven day services could only be funded by cuts elsewhere. [N.B. this discrepancy was noted in a briefing from 17/12/15 by the King's Fund, Nuffield Trust and Health Foundation]

19 July 2016
A mental health strategy implementation plan has been published by NHS England.  'Implementing the Five Year Forward View for Mental Health' sets out how new funding, which has already been promised, will be made available to CCGs.  Funding will go on: integrating IAPT (Improving Access to Psychological Therapies) with physical health; six pilot sites to develop new approaches to secure and children's mental health; improvement of perinatal mental health services; and a roll-out of Liaison and Diversion services for people involved in the criminal justice system.

17 July 2016
NHS Trusts had to borrow £3.36bn from the Treasury last year to meet budget shortfalls, made up of £2,825m for revenue and £530m for capital according to figures collected by the House of Commons library for Liberal Democrat health spokesman Norman Lamb.  The money went to 109 of the 156 acute trusts and one mental health trust.

20 July 2016
Patients who do not have contact with a GP for five years could be deregistered if they do not respond to two letters asking them to confirm their details, in an extension of 'list cleansing' begun by NHS England in some areas from 2013.  Pulse magazine has seen a contract with Capita under which it will request a list from GPs in the eleventh month of every contract year of all patients not seen for five years, and write the letters.  GPs will then have six months to confirm the existence of those who have not responded.  The aim is to save money as GPs are paid a capitation fee of on average £136 for each registered patient.  Doctors' leaders criticised the proposal because of the extra work for GPs, inconvenience to patients and the risk that some patients would unfairly be deregistered.

20 July 2016
A Scottish child poverty bill is to be introduced allowing the Scottish Government to reintroduce statutory child poverty targets that were abolished by the Westminster Government earlier this year, Nicola Sturgeon has announced.  A consultation setting out proposals for a bill is to be published in the summer.  The UK government's Welfare Reform and Work Act 2016 repealed elements of the Child Poverty Act 2010, including the target of ending child poverty by 2020 and the requirement to produce child poverty strategies and report on them annually.

21 July 2016
Bursaries for student nurses and midwives are to end in 2017, the Government has confirmed, following a consultation.  The Government argues that replacing the bursaries with loans means the cap on the number of training places can be lifted.  Two thirds of those applying for a university nursing course are currently not offered a place.  The changes were criticised by representatives of nurses and midwives who were concerned that the prospect of large debts could people off applying for training.

18 July 2016
Three junior health ministers have been appointed, Philip Dunne, the most senior of the three as Minister of State for Health, Nicola Blackwood as Parliamentary Under Secretary of State for public health and innovation and David Mowatt as Parliamentary Under Secretary of State for community health and care.

22 July 2016
Jeremy Hunt has been criticised for only submitting his department's accounts on the day Parliament rose for the summer recess, in a letter from the chair of the Public Accounts Committee, Meg Hillier. The letter expressed dismay at the delay in publishing the departmental expenses and said it "smacks of an underhand attempt to cover up the poor state of finances in your department." The department only stayed within its £118.3bn budget by some last minute changes including using £950m of capital as revenue and receiving 417m more than planned from national insurance receipts because of an 'administrative error'.
NAO report on health financial accounts:

19 July 2016
Larger scale general practice reduces patient satisfaction, makes no difference to quality of services but does help struggling GP practices to cope better through increased operational efficiency, according to a study by the Nuffield Trust in collaboration with the Royal College of GPs, 'Is Bigger Better? Lessons for Large Scale General Practice'.  The report looked at two national surveys and three in-depth case studies and was informed by a literature review.  While larger practices and federations improved patient access, patients valued having a relationship with their own doctor and smaller practice team.  It concludes that policy makers should be realistic about the pace at which large-scale organisations can contribute to service transformation.  Three quarters of practices are now working collaboratively.
Press release:

21 July 2016
The government does not have a coherent planning and management framework, which leads to poor value for money and a lack of long-term, joined-up thinking, the NAO has said on a report on progress with single departmental plans and another on the comprehensive spending review process.  This is despite there having been some improvements.

24 July 2016
Dr Kate Granger has died. Dr Granger, a consultant geriatrician, was diagnosed with incurable cancer in 2011 at the age of 29.  On the basis of her experience as a patient, and the importance of the doctor's personal approach, she started the hellomynameis campaign, to encourage doctors to introduce themselves, which has spread widely.  With her husband, she has raised £250,000 for cancer.  The Kate Granger Compassionate Care Awards were started in her name and will be presented for the third time this September.

15 July 2016
The Government's child obesity strategy could be delayed until the autumn it is reported.  It is also said that the latest drafts of the strategy circulating in Whitehall have watered down previous commitments. Firms were initially to be given six months to produce plans saying how they would reduce sugar content by 20% in five years but in the latest draft were being merely challenged to reduce sugar levels.  The delay was later confirmed by the Government.  The BMA called the delay 'completely unacceptable'.

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