Group items tagged

A new report has highlighted that while NHS trusts are well placed to drive the new Labour government's desired healthcare transformation, additional resources are essential to fully realise this vision. Published by NHS Providers, the report explored how trusts are innovating and adapting to deliver the three key shifts outlined by the government: from hospital to community-based cafe, from analogue to digital, and from treatment to prevention. Titled "Providers Deliver: shifting care upstream," the report cited some successful approaches trusts have taken to ensure patients can get the care they need in the right place at the right time. Examples include: Tackling the wider determinants of health to improve patient flow - Hampshire and Isle of Wight Healthcare NHS Foundation Trust Reducing demand for emergency care by providing support at home - East Lancashire Hospitals NHS Trust Improving mental health crisis care from the ground up - North Staffordshire Combined Healthcare NHS Trust Harnessing a culture of continuous improvement to deliver care in the right place - Walsall Healthcare NHS Trust Taking the next step from hospital at home to early intervention - Hertfordshire Community NHS Trust

In his first speech as Secretary of State for Health and Social Care, Wes Streeting MP acknowledged that the NHS is in crisis while outlining his mission to save the health service. Streeting described the current state of the NHS as "broken," noting its failure to meet the needs of both patients and dedicated healthcare professionals. "When we said during the election campaign, that the NHS was going through the biggest crisis in its history, we meant it. "When we said that patients are being failed on a daily basis, it wasn't political rhetoric, but the daily reality faced by millions," he said on Friday (5 July). The new health secretary remarked that previous governments had been unwilling to admit these simple facts.

A new analysis by the Nuffield Trust has revealed that NHS trusts in England are experiencing their worst financial deterioration in a decade, raising concerns that the government's reform plans could be at risk. The report found that the NHS trust sector, which makes up three-quarters of NHS day to day spending, recorded a £1.2 billion overspend last year, amounting to 0.9% of income in 2023/24. This is double the previous year's overspend, recorded at £448 million, and significantly worse than the modest financial surpluses seen in 2020/21 and 2021/22. The sector is in "as precarious a position it was in immediately prior to the pandemic," the report said. NHS trusts in the most deprived areas suffered the worst financial deterioration in 2023-24, with North West and Midlands reported the deepest deficits, accounting for 2.2% and 1.5% of revenues, respectively. The North East and Yorkshire have also seen the steepest declines in financial health since 2022/23. The underlying gap between stable incomes and outgoings across the provider sector was at least £4.5 billion last year.

The government has decided to refresh the NHS workforce plan, prioritising on shifting care from hospitals and into the community. The revised plan, expected to be unveiled in the summer 2025, aims to ensure the workforce is used effectively to support the delivery of the upcoming 10-Year Health Plan. Health secretary Wes Streeting explained the need to revise the plan citing Lord Darzi's report, which highlighted the dire state of the NHS, including that "too many people end up in hospital because there aren't the resources in the community to reach patients earlier." "Our 10 Year Health Plan will deliver 3 big shifts in the focus of healthcare: from hospital to community, analogue to digital, and sickness to prevention. "We will refresh the NHS workforce plan to fit the transformed health service we will build over the next decade, so the NHS has the staff it needs to treat patients on time again," Streeting said.

Poverty not only takes a significant toll on people's health but also leads to additional costs for the National Health Service (NHS). Rise in deep poverty, cost-of-living crisis, and high pressure on NHS services have worsened the situation, according to a study published by The King's Fund this week. The report underscored that poverty and deprivation contribute to a greater prevalence of diseases, difficulties in accessing health care, late or delayed treatment, and worse health outcomes. These challenges could be seen across various NHS services, spanning from emergency care to dental services Additionally, it revealed that 30 per cent of people living in the most deprived areas have turned to 999, 111, A&E or a walk-in centre because they could not access a GP appointment. In 2016, the Joseph Rowntree Foundation (JRF) estimated the cost of poverty on health care at £29 billion (£34 billion in current prices). As the proportion of people living in deep poverty has risen, the situation has worsened. In 2021/22, six million people were living in very deep poverty, up from 4.5 million two decades ago. Currently, more than one in five people in the UK are estimated to be living in poverty, the report noted. Deprivation is linked to a range of diet-related health problems, including cardiovascular disease and diabetes, as well as mental illness. According to the report, the depression rate is two times higher among people living in the most deprived areas, compared to the least deprived areas.

The consequences of NHS workforce crisis is not limited to general practice, community pharmacies are also suffering, commented Community Pharmacy England after the General Medical Council (GMC) published a report on Friday (23 June) which warned of the burnout in the workforce. The report calls for urgent actions to break a 'vicious cycle' of unmanageable workloads, dissatisfaction and burnout that is causing UK doctors to take steps to quit. Chief Executive Janet Morrison, said: "The GMC's report is yet another clear signal of the scale of the mounting the NHS workforce crisis, and this is not limited to general practice: community pharmacies are also suffering the consequences of it." "Pharmacy teams are overstretched, feeling immense pressures, and dealing with significantly increased workloads. Pharmacy owners are also finding it impossible to make ends meet, not least given the rising staffing costs which are being driven up by workforce issues. Findings show the number of doctors who reported working beyond their rostered hours on a weekly basis rose from 59% in 2021 to 70% in 2022, and 42% said they felt unable to cope with their workload each week (up from 30% in 2021). Just half said they were satisfied in their work, down from 70% in 2021.

The National Pharmacy Association (NPA) has welcomed the Chancellor's commitment to increase the NHS budget, hoping that 'community pharmacies benefit from this investment'. The association is urging the government to address years of underfunding so that community pharmacies can avoid staff lay-offs to cover the increasing costs of the national living wage. The government's uplift of the National Living Wage was confirmed in its latest budget announcement to tackle the cost of living crisis. The NHS budget will also be increased in each of the next two years by £3.3bn. A recent NPA commissioned report by Professor David Taylor from University College London predicted that wage inflation and other cost pressures could combine with funding cuts to lead to cut-backs and pharmacy closures.

Expressing apprehension over the concerning decline in the nursing workforce, Sir Julian Hartley, CEO of NHS Providers, urged the forthcoming government to bolster investment in nursing education and enhance support for student nurses. Recent analysis from the Royal College of Nursing (RCN) has projected that the NHS Long Term Workforce Plan will fall short by 10,000 new nurses by 2025. Commenting on the RCN analysis, Sir Hartley underscored the critical importance of having an adequate number of nurses to ensure the delivery of safe, high-quality patient care. "Without enough nurses, the delivery of safe, high-quality patient care is compromised," he said. He cautioned that the predicted shortfall in nurses would exacerbate existing pressures on the NHS, resulting in long waiting times, delayed treatments and staff burnout.

The Department of Health and Social Care (DHSC) has published Lord Darzi's report on the state of NHS England, which revealed that the health service is in "serious trouble." Lord Darzi pointed out that the NHS has failed to meet key promises made to the public since 2015 and patient satisfaction is now at its lowest ever level. Rising waiting times and difficulties accessing GPs were highlighted as major concerns. "There are huge and unwarranted variations in the number of patients per GP, and shortages are particularly acute in deprived communities," the report said. Darzi described the state of A&E as "awful", noting that nearly 10 per cent of patients wait 12 hours or more today. Additionally, Lord Darzi's investigation found that the NHS budget is not being optimally allocated, noting that "too great a share is being spent in hospitals, too little in the community, and productivity is too low."

The new Labour government has pledged to deliver an extra 40,000 NHS appointments, operations and diagnostics every week, equivalent to two million a year, to tackle the ongoing waiting list crisis. It aims to ensure that 92 per cent of patients start routine hospital treatment within 18 weeks by the end of this parliament - a target that has not been met for nearly a decade. However, a new analysis by healthcare consultancy CF (Carnall Farrar) and the NHS Confederation has revealed that these extra appointments alone will not be enough to achieve the 18-week Referral To Treatment (RTT) target by 2028/29. The study estimates that 40,000 extra appointments per week would deliver only about 15 per cent of the additional activity required to hit the 18-week target, assuming demand continues to grow at current rates and care delivery remains unchanged. While the report acknowledged that increasing capacity is a positive step, it stresses that further reforms and transformations in care pathways are necessary to bridge the gap.

A Labour Party analysis of NHS trust figures has revealed that around 148,000 people died last year while waiting for treatment in England. This is more than double the figure recorded in 2017/18, which stood at around 60,000 deaths. It even surpasses the mortality rate observed in 2021, during the peak of the Covid pandemic. The Labour Party obtained the data through a freedom of information request sent to every NHS trust in England. Out of the 169 acute and community trusts contacted, 80 responded. The total number of deaths reported by the respondents was 61,396. Extrapolating this figure to all trusts would suggest a total of 148,227 deaths.

In a recent interview with The Telegraph, health secretary Steve Barclay stated that he has asked his officials within DHSC to look at a "pharmacy first" approach to alleviate pressures on A&E departments in order to avoid the widely predicted NHS winter crisis. On the face of it, this a welcome if long overdue recognition that community pharmacy is an essential part of our national healthcare infrastructure alongside our GP and A&E colleagues. But let's not get carried away - we have had lots of praise from politicians in the past which have not then been backed by firm commitments for a sustainable future for the network. Could this be a turning point? I hope so, but I am not confident it will be. I fear this may turn out to be another emergency stop-gap measure which does nothing to secure the long-term viability of the sector in England. The role of community pharmacy during the recent Covid pandemic demonstrated clearly how important we are to ensure people have easy access to essential healthcare support, advice and services. The NHS winter crisis can only be avoided or at least mitigated if the potential of the community pharmacy network to provide more patient care services is unlocked and that Barclay requires you to end pharmacy funding austerity and start investing. The Treasury will no doubt say there is no more money, but what then the alternative other than a NHS winter crisis? And, of course, treating people in secondary care settings is far more costly than community pharmacy based interventions.

A winter NHS crisis is inevitable unless the government acts now to reverse the worrying decline in community pharmacies. Years of government underfunding could see 3,000 pharmacies in England - around a third of the network - having no option but to shut their doors to patients in the next few years. That figure is based on independent assessments from Ernst & Young and UCL/LSE healthcare professors: it is not scaremongering - it is the reality the country faces. Fifty per cent of pharmacies are already in financial distress because government funding has been falling in real terms since 2019 and that figure is predicted to rise to 75 per cent within the next two years. The government needs to act now and invest in pharmacy or sleepwalk into a healthcare disaster as we have seen with access to dentistry care. Prescription volumes have risen consistently year-on-year by roughly 2 per cent which means fewer pharmacies doing more work and under greater pressure than a decade ago. Ten years ago around 11,200 pharmacies in England were dispensing roughly 79,000 prescriptions; nowadays around 11,500 are dispensing roughly 89,000 prescriptions. The secretary of state recently asked pharmacy to do more to avoid a winter NHS crisis and at the same time said there will be no new money to pay for those additional services. This at a time when the network is in decline with random unplanned pharmacy closures - 640 closures since 2016 - and pharmacy staff face huge workload pressures as prescription demand is increasing year-on-year. The government's approach to pharmacy literally does not add up: the pharmacy contract is not fit-for-purpose now let alone dealing with a NHS winter crisis.

Long waits for an ambulance or surgery led to the death of 112 people, and nearly 8,000 more people suffered harm while waiting for help in England last year. The data from NHS England, obtained by The Guardian, show that patient deaths arising directly from care delays have risen more than fivefold over the last three years. In 2019, there were 21 patient deaths due to NHS care delays, and 96 people suffered "severe harm" as compared to 152 last year. Adult mental health care was mostly affected with 471 patients experiencing harm due to delays, followed by childbirth care (253), eye problems (221), and trauma and general surgery (207). There has been increase of 97 percent in the overall number of people suffering some degree of harm, from 3,979 in 2019 to 7,856 in 2022.

As the countdown to the next UK election begins, the King's Fund has identified three priorities to improve public health. The national action would be taken by the future government to fix the "NHS and social care" in the country. The health policy think tank said it would prioritise "improving access to out-of-hospital care", making "careers in health and social care" more attractive and tackling the biggest risk factors affecting people's health. It highlighted that workforce crisis is one of the biggest challenges faced by the National Health Service (NHS) and social care services in England while citing "years of poor planning and fragmented responsibilities" as the reason for widespread staff shortages. As per the King's Fund's data, there were more than 125,000 vacancies across the NHS workforce in England in October 2023, not including primary care vacancies such as GPs, and 152,000 vacant posts in the adult social care workforce.

Staff shortage has begun to bite the community pharmacy sector with several high street pharmacies closing doors due to workforce crisis triggered by the NHS poaching. More than 200 pharmacies closed last year and several are reducing their hours, posing a significant risk to patients' access to care, medicines and advice. Many in the industry have raised concerns related to workforce crisis and warned that plans for community pharmacies to help ease pressure on GP surgeries could also take a hit. The NHS plans to recruit a total of 6,000 pharmacists in England by 2024, equivalent to nearly three full years of new pharmacists. Since 2019, 3,000 pharmacists have been recruited into NHS primary care networks, which accounts for around 10 per cent of the community pharmacist workforce.

Trust leaders involved in the New Hospital Programme (NHP) have warned that further delays in the government scheme will lead to more patient harm, disappointment among staff, and higher costs for taxpayers. According to NHS Providers, delays in the government scheme that promised 40 new hospitals in England by 2030 are draining millions of pounds from scarce NHS funds every month. Some trusts are compelled to spend over £1 million a month from their under-pressure budgets due to spiraling cost pressures, on-hold building projects, and the bill for having to patch up deteriorating sites. While there has been some progress over the past year, trust leaders remain apprehensive that "uncertainty over funding and shifting timetables risks putting their promised buildings further out of reach."

The National Pharmacy Association (NPA) has called on the NHS and the Department of Health to immediately publish the government-commissioned analysis of pharmacy underfunding and reveal the true scale of the crisis. Commissioned by NHS England, the long-awaited independent review is expected to "lay bare the perilous financial state" of community pharmacies, which is a vital part of the nation's health infrastructure. However, the NPA is concerned that the government may delay its release until after current funding consultations are concluded. The NPA argued that the public needs to understand the fragile nature of the pharmacy network before any new deal can be agreed. It has also warned health officials not to hide "the true scale of funding needed to reverse a decade of swingeing cuts", which has forced record numbers of pharmacy closures. NPA chair Nick Kaye said: "It would be a scandal to keep that evidence buried secret and leave MPs, pharmacies and the public in the dark." He acknowledged that the new government has inherited a crisis in pharmacy funding and emphasised that it will need to take "strong action" to maintain access to medicines.

Community pharmacies played a central role in the government's response to the Covid-19 pandemic, delivering more than 22 million jabs in the past 12 months. Besides delivering millions of jabs, latest figures from NHS England and NHS Improvement (NHSE&I) revealed a 50 per cent increase in the number of pharmacies delivering Covid boosters compared from October 2021 to January 2022. NHSE&I released the data on Friday (January 14) to thank community pharmacy teams for their work during the crisis time. Lauding the efforts made by community pharmacy teams during the pandemic, Pharmaceutical Services Negotiating Committee (PSNC) director of NHS Services Alastair Buxton said: "Just over a year ago we were fighting for Government recognition of the part community pharmacy could play in administering Covid vaccines, so a year later it is great to see the efforts of the pharmacy vaccination sites being praised by NHSE&I, with recognition of the significant role they have played in the overall programme.

In a decisive move highlighting the financial strain faced by community pharmacies, the National Pharmacy Association (NPA) submitted a £108 million invoice to the Department of Health and Social Care (DHSC) today (16 May). According to the NPA, this substantial sum represents the amount that pharmacies in England personally covered for the dispensing of NHS medicines last month, as a result of inadequate funding. "The £108m figure is an average monthly figure based on the loss to pharmacy incomes over the past decade," it said. The association believes that mass closures can be prevented only when the government stops expecting pharmacies to subsidise the cost of delivering NHS care. NPA chief executive Paul Rees, said: "The soaring costs of dispensing medicine coupled with declining real terms funding has led to community pharmacies in England having to subsidise the dispensing of drugs to the tune of £108m a month.