The essential stories and biggest talking points in the NHS

No more ‘nice and shiny’ spending

NHS England has decided to back commissioners in their long running battle against “low priority” medicines.

The national policy setter has decided to join in with NHS Clinical Commissioners’ to “save the NHS pound” and limit the funding of medicines deemed “low priority” or those of “limited clinical effectiveness”.

On Thursday, NHS England will launch the first leg of this medicines savings marathon, with a bid to tackle £128m of spending on 10 products. These include items that have a cheaper but equally as effective alternative, to the more difficult decisions such as gluten-free items. The latter has caused some controversy recently, with more and more CCGs choosing to cut funding.

It is understood that consultation on the first phase will be published soon, while NHSCC will look to carry out future phases of savings.

One of the co-chairs of NHSCC told HSJ the NHS cannot be a “sweet shop” for patients that want all the “nice and shiny” products on the market.

Although controversial to some, this plan will likely be welcomed by commissioners who can find it difficult (due to public opinion) to stop funding certain medicines.

However, there is one pill the public should be happy to lose – Co-proxamol. The strong pain killer was taken off the market in 2005 due to safety concerns, but according to NHSCC the NHS is still spending £8.5m a year on it.

The best and worst regions for primary care

In-depth HSJ analysis has, for the first time allowed us to have a detailed picture of the quality of GP services in every area of the country.

We’ve analysed more than 6,000 CQC GP inspection reports to reveal the proportion of surgeries in each CCG and STP area that received a rating of inadequate, requires improvement, good or outstanding. Although the CQC has only released 84 per cent of GP ratings to date, the data has revealed interesting variations already.

There is wide variation across the country, with five CCGs with at least 10 per cent of practices rated inadequate. In contrast, 32 CCG areas have at least 10 per cent of GPs rated outstanding, with four of those having more than a fifth of GPs in their region rated outstanding.

On an individual CCG basis, there is not a clear pattern to be found based on per capita GP spend or levels of deprivation but it’s hard not to notice the low income, urban similarities between struggling areas in Greater Manchester, east London and south Essex.

Rebecca Rosen, senior fellow at the Nuffield Trust, picked out similarities between the high performing CCGs and STP areas – pointing out the Tower Hamlets CCG and Rushcliffe CCG, who have 10 and 27 per cent of surgeries rated outstanding respectively, offer strong quality improvement leadership, use quality data and peer view, and have strong leaders.