Reactions to the comprehensive spending review and the rest of today’s news
5.32pm: “The £3bn of health and social care funding that will be used to commission joint services by the NHS and local councils is good to see but should not only benefit the elderly,” says Lord Victor Adebowale, chief executive at Turning Point.
He added, “the distinction between health and social care is a meaningless one to the service user and we need to ensure we keep championing greater integration between the two.”
“The inclusion of a government cap on disability and housing benefits is a real worry and puts extra pressure on health and social care when people do not have the support they need to live independent lives. I believe that the case for more adult social care funding is not just ethical, it is economic.”
“What we need is an honest appraisal by this Government of cost; do cuts to social care and disability benefits actually save money or is the cost of caring simply shunted from one department’s budget to another’s?”
3.32pm: Rebecca Cotton, acting deputy director of the NHS Confederation’s Mental Health Network, has spoken on the nnouncement by Norman Lamb for four pilot schemes, in which mental health nurses and police will jointly respond to incidents where police believe people need immediate mental health support.
“Joined-up working between health services, social care and the police is absolutely crucial to getting this right. The pilot schemes announced today are therefore very welcome”, she said.
“By joining the dots to anticipate the needs of individuals and communities, and by planning appropriately, we can ensure people experiencing a mental health crisis get the appropriate, caring response they need at one of the most difficult times of their lives.”
1.58pm: A video from the King’s Fund showing An alternative guide to the new NHS in England.
1.44pm: “Great Ormond Street gagged top doctor over safety fears” reports The Guardian. The story is taken from Private Eye’s article that Great Ormond Street children’s hospital used a confidentiality agreement with Dr Hilary Cass.
12.52pm: Medics at the BMA’s annual representative meeting in Edinburgh admitted that some patients could be left on the controversial end-of-life care pathway for weeks without having their cases reviewed.
Professor Baroness Ilora Finlay, a crossbench peer and palliative care doctor, said doctors needed to be aware that the LCP was not a “one-way street”, pointing out 3 per cent of patients put on it do not end up dying.
12.51pm: Charity Diabetes UK has warned some hospitals are doing “more harm than good” to people with diabetes, after an audit suggested thousands of patients each year could be developing a life-threatening but preventable complication due to poor care.
12.45pm: Ben Clover adds:
Announcement on it due today. Problem last time, everyone agrees principle (fewer centres) no one agrees where. More diff. with 33 centres
— Ben Clover (@BenClover) June 27, 2013
12.44pm: HSJ reporter Ben Clover tweets:
After meeting on Friday, new paediatric heart surgery review will lk at adult surgery also. Cmplctng further what was already v complicated
— Ben Clover (@BenClover) June 27, 2013
12.25pm: Following recent coverage that senior directors at NHS Direct warned it was not safe to go live with one of its biggest NHS 111 contracts but were overruled, HSJ reporter Sarah Calkin, who uncovered the story, discusses the future for NHS Direct and likely implications for NHS 111 contracts in a podacst.
11.50am: There’s been a lot of comments left on our report that the further 10 per cent real-terms cut in health administration budgets revealed in yesterday’s spending review could render some clinical commissioning groups “unsustainable”.
One anonymous commenter writes: “Area teams need to go. CCGs need to be allowed to do the job without junior inexperienced staff standing over their shoulders looking for ‘assurance’. If CCGs don’t come up to the mark then the DH must deal with the CCG but in the meantime the ’ homework markers’ need downsizing.”
This was replied also anonymously with: “Anon 7:45… I agree, and I work for an Area Team! A lot of people here are still in the ‘SHA’ mentality, which won’t help, but that isn’t the biggest problem”.
“The biggest problem is that quite a few people still don’t know what they’re supposed to be doing, so are making it up as they go along. Indeed, David Nicholson affirmed this by stating they were ‘making it up as they go along’ at a recent staff meeting.”
“There are those of us at NHS England who really could add some value, but without any mandate, it’s proving impossible to make progress”.
11.24am: Tweet from Your Humble Servant
— Your Humble Servant (@yrhumbleservant) June 27, 2013
10.55am: Under the headline “Doctors refuse to enforce checks on health tourists” The Times reports a vote at the BMA’s annual meeting in Edinburgh at which members voted to refuse to check patients’ immigration status, saying “they were not agents of the UK Border Agency”.
10.53am: The Financial Times’s public policy editor Sarah Neville writes that the next comprehensive spending review – which will take us beyond 2016 – could reshape the government.
“Some of the hardest future decisions will concern how to fund the NHS where demand is outstripping its inflation protected budget”, she writes.
“As recently as the last election few would have suggested that consideration be given to extending user charges. Now it is close to becoming orthodoxy that a universal free NHS may be unsustainable.”
10.47am: Good day for Foundation Trust Network chief executive Chris Hopson.
The FTN’s “Robbing Peter to pay Paul” line was quoted in The Times’ page nine lead above the RCGP, Andy Burnham, The King’s Fund and the Association of Directors of Adult Social Services.
It was headlined: “Chancellor ‘raids’ NHS to find £1bn to improve pensioners’ social care”.
10.40am: Nuffield Trust chief economist Anita Charlesworth comments on the spending review:
“Within the overall allocation for health, the administration budget is set for further cuts of 10% in real terms. It is absolutely right that the front line should take priority when resources are scarce. However, with Clinical Commissioning Groups and the Care Quality Commission playing a vital role in ensuring quality and security of services, ministers must ensure that they have enough funding to do their jobs well. Many CCGs are already expressing concern about the financial pressure they are under given their current allocations.”
She adds “We need further clarification on where these cuts will fall, and assurance that the Government has fully considered any potential impact on the commissioning and oversight of care.”
“The decision to allocate £3.8 billion to fund joint work across health and social care has the potential to help enable new ways of working which could meet the needs of patients better while improving efficiency,” she said in a statement.
10.30am: The Times reports the result of the Chancellor’s spending review yesterday as a breach of the NHS’s ring-fenced funding principle.
Their report said: “To make his figures add up, Mr Osborne had to breach the ringfence that protects NHS spending. The health service will have to find an extra £1bn to help to fund more integration between hospital care and social care.”
Under the headline “Key services threatened as councils face 10% cuts and freeze on tax” Whitehall editor Jill Sherman wrote: “The Chancellor tried to ease the pain by announcing a £3.8bn pot of cash for social care, more than half of which will come from the NHS budget.”
10.27am: Jeremy Taylor, chief executive at National Voices tweets
Despite NHS ring fence net effect of the spending review is likely to be damaging to health because damaging to the poor and vulnerable.
— Jeremy Taylor (@JeremyTaylorNV) June 27, 2013
10.23am: The Daily Mail has reported people who worry about being stressed can double their risk of suffering a heart attack.
According to the paper it is the first time a link has been discovered between heart disease and people’s own view on how stress is affecting their health.
The research suggests doctors should take a patients’ perspective into account when managing stress-related complaints. It could also mean that helping patients to unwind can reduce the risk of cardiovascular disease.
The study followed more than 7,000 civil servants over a period of up to 18 years. Participants, who had an average age of 49.5, were asked to what extent they felt day-to-day stress had affected their health.They were also asked about lifestyle factors such as smoking, alcohol consumption, diet, and exercise, and their medical background was taken into account.
NHS records were monitored to see how many fatal or non-fatal heart attacks occurred. Participants who felt stress was harming their health ‘a lot or extremely’ – 8 per cent of the group – were found to have double the risk of a heart attack compared with those who said it had no significant effects.
10.18am: HSJ has an updated story on the £3bn transfer to social care. Health secretary Jeremy Hunt says the government’s decision to create a £3.8bn joint commissioning pot for the health and social care needs of vulnerable people is a “big game changer”.
10.12am: 400 medical students at King’s College London are to resit their final exams because the paper they took replicated questions that featured on a revision “app” for smartphones and tablets designed by their lecturers.
9.58am: The Daily Telegraph also reports a story that HSJ covered yesterday that the elderly will benefit from “joined up” health and care services to “end the scandal of older people trapped in hospitals” according to the announcement by George Osbourne in the spending review.
It also carries a report that doctors have expressed concern about the misuse of the Liverpool Care Pathway, claiming that some patients have been placed on the end-of-life scheme for weeks on end. Delegates at the British Medical Association’s annual conference in Edinburgh called for changes in the way care for those close to death is delivered.
9.55am: Nurses are to patrol alongside the police after it emerged that officers spend up to 25 per cent of their time dealing with mentally ill people reports The Daily Telegraph. Street “triage teams” are to be tested in four forces - North Yorkshire, Devon and Cornwall, Sussex and Derbyshire as part of initiative funded by Department of Health.
8.38am: In case you missed HSJ’s full coverage of the comprehensive spending review announced yesterday, you can catch up on our dedicate site.
8.35am: It has now been nearly six months since the Francis report came out. The government and all health related agencies have responded in greater or lesser detail to the findings of Robert Francis QC, and Mike Richards has been appointed as the chief inspector of hospitals. Chris Gordon considers the priorities when planning how trusts will implement the recommendations into quality governance and patient experience on innovation and efficiency channel today.