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Take a look at a selection of our recent media coverage:

Health inequalities led to one million early deaths in England in 2010s, as Europe fared better

9th January 2024

Health inequalities saw more than one million people living in 90% of areas in England living shorter lives than they should have between 2011 and the start of the Covid-19 pandemic – equivalent to the whole population of Birmingham, or that of Edinburgh and Glasgow combined, new research has found.

According to research led by University College London’s Institute of Health Equity (IHE), the period from 2011 to 2019 saw more than a million people dying earlier than they otherwise would have done had they experienced the death rates seen in the least deprived decile of areas.

Of these excess deaths, 148,000 were additional to what might have been expected based on levels in the two years prior to 2011, the report – titled ’Health Inequalities, Lives Cut Short’ – said.

And in 2020, the level of excess deaths rose by an additional 28,000 compared to those over the previous five years.

To contextualise the UK’s downwards health trend, the IHE analysed European Union data and compared healthy life years (HLY) – the number of years a person is expected to continue to live in a healthy condition, and also called disability-free life expectancy – in the UK to other European Union countries.

In 2014, both males and females in the UK had a higher average number of healthy years lived (HYL) than those in the EU. However, by 2017, HLY in the UK had stagnated for men, and fallen for women.

In the same period, HLY increased by more than two years in the EU. Consequently, 10 EU countries had higher HLY than the UK for males, and 14 had higher HLY than the UK for females.

UCL IHE Director, Professor Sir Michael Marmot, said: ’If you needed a case study example of what not to do to reduce health inequalities, the UK provides it. The only other developed country doing worse is the USA, where life expectancy is falling.

’Our country has become poor and unhealthy, where a few rich, healthy people live. People care about their health, but it is deteriorating, with their lives shortening, through no fault of their own. Political leaders can choose to prioritise everyone’s health, or not. Currently they are not.’

Referring to this ’dismal state of affairs’, he is calling on political party leaders and MPs to prioritise health equity and wellbeing.

’Important as is the NHS – publicly funded and free at the point of use – action is needed on the social determinants of health: the conditions in which people are born, grow, live, work and age. These social conditions are the main cases of health inequalities,’ he said.

Ahead of the general election, the IHE is also proposing the appointment of an independent health equity commissioner and the establishment of a new cabinet-level health equity and wellbeing cross-departmental committee.

In 2020, Sir Michael’s ’Build Back Fairer: The Covid-19 Marmot Review’ document highlighted how pre-pandemic social and economic conditions contributed to the unequal Covid-19 death toll.

The UK cabinet office cited the report as ‘the most comprehensive early assessment of how Covid-19 exacerbated existing health inequalities’ when he was named in the 2023 King’s New Year Honours.

Last January, Sir Michael criticised the UK Government’s short-term policies being announced and rolled out, stating that they damage the service overall, and warning health leaders to be ‘aware of short-term fixes that might undermine a longer term agenda’ for the service.

Hospital discharge funding in England comes with strings attached, says King‘s Fund report

15th December 2023

One-off payments to reduce delayed hospital discharge ‘come with insufficient advance notice for effective planning’, forcing providers to resort to short-notice residential care rather than supporting patients at home, a new King’s Fund report has found.

The report, ’Hospital discharge funds: experiences of winter 2022-23’, looked in-depth at six health and care systems. The authors spoke to local authorities, integrated care system leads, acute trusts, Healthwatch and local care provider associations.

Commissioners and providers across each area ‘strongly criticised burdensome monitoring requirements’ and said funding was rarely available to prevent hospital admissions.

Areas did manage to use the funding to put services in place and support social care, but ‘were not confident they were spending funding as effectively as possible’.

The funding in question was provided in two tranches: the Adult Social Care Discharge Fund of £500m from the Department of Health and Social Care, and a further hospital discharge fund of £250m from NHS England. Each had different conditions, which were not known in advance, authors pointed out.

The report found that the six sites ‘did not all have a shared understanding of local causes of delayed discharges’ or ‘priorities for action’. Authors heard of more than 20 reasons for delayed discharge, although lack of staffing was a consistent theme.

The report also highlighted NHS England data which found that although many more patients were discharged home simply – seen in 85% of cases – compared with the predicted 50%. In addition, three times more patients needed 24-hour bed-based care on discharge (3%) compared with the predicted 1%.

Delayed hospital discharge a ’longstanding problem’

Simon Bottery, a senior fellow at the King’s Fund and co-author on the report, said: ’Delayed hospital discharge is a widespread and longstanding problem that affects thousands of patients, their families and loved ones. The underlying reasons for delays are often complex and vary between local systems, though workforce issues are often at the root of them.’

He added: ’Our analysis makes clear that the Department of Health and Social Care should only use short-term, ring-fenced funding on an exceptional basis and should ensure sufficient notice to sites so that they can plan for it. It’s welcome that this has been largely done for 2023/24 and 2024/25.

’It’s also clear that places should invest effort in developing shared understanding of discharge performance, the causes of delays and the priorities for action to tackle them, as we found that these were often lacking between system partners.’

HIV given ‘testing turbo boost’ with expanded opt-out programme in emergency departments

1st December 2023

An opt-out testing programme for bloodborne viruses in emergency departments in England is to be expanded after the success of schemes in extremely high prevalence areas of HIV, the Department of Health and Social Care has announced.

Almost 4,000 people have been identified as having HIV and hepatitis B and C through the opt-out testing programme that was launched in April 2022 at 34 emergency departments in areas with the highest prevalence of HIV.

The new testing programmes will be launched in 46 further emergency departments across 32 high-prevalence areas of England.

Backed by £20 million in funding from the National Institute for Health and Care Research, the expanded initiative is expected to save, and improve the quality of, thousands of lives, particularly from groups less likely to come forward for routine testing.

It is part of the Government’s ambition to reduce new HIV transmissions in England by 80% in 2025 and end new transmissions of HIV by 2030, all while getting people into the right care.

Richard Angell, chief executive of the Terrence Higgins Trust, referred to the announcement as a ‘testing turbo boost that’s needed if we are to end new HIV cases by 2030’.

‘It’s hugely significant that an additional two million HIV tests will be carried out in A&Es over the next year thanks to a temporary but wholesale expansion of opt-out HIV testing to 46 additional hospitals,’ he said.

‘The evidence is crystal clear: testing everyone having a blood test in emergency departments for HIV works. It helps diagnose people who wouldn’t have been reached via any other testing route and who have often been missed before.

‘It also saves the NHS millions, relieves pressure on the health service and helps to address inequalities with those diagnosed in A&E more likely to be of black ethnicity, women and older people.’

Also commenting on the announcement, health and social care secretary, Victoria Atkins, said: ‘As well as promoting prevention for all, the more people we can diagnose, the more chance we have of ending new transmissions of the virus and the stigma wrongly attached to it.

‘This programme, which improves people’s health and wellbeing, saves lives and money.’

The existing bloodborne virus opt-out testing programme provides joined-up care so previously undiagnosed patients, or those disengaged from their care, gain access to medication and a treatment and care pathway. 

During the first 18 months of the programme, 33 emergency departments conducted 1,401,866 tests for HIV, 960,328 for hepatitis C and 730,137 for hepatitis B.

It identified 934 people unknowingly living with HIV or disengaged with their care. A further 2,206 people were identified as having hepatitis B and 388 were disengaged from hepatitis B care. And 867 people were found to be living with hepatitis C and 186 were identified as being disengaged from care.

Professor Kevin Fenton, the Government’s chief advisor on HIV and chair of the HIV Action Plan Implementation Steering Group, said: ‘We know HIV is most commonly unknowingly spread by people who don’t know their status. Knowledge is power in preventing HIV transmission and accessing life-saving care.’

He added: ‘The opt-out testing programme will boost our progress to identify the estimated 4,500 people who could be living with undiagnosed HIV and help us ensure we meet our 2030 ambition, with the possibility to save thousands of lives in the process.’

Consultants announce additional strike dates after rejecting ‘final’ pay offer

17th July 2023

The BMA has announced two new strike dates for hospital consultants in England despite the Government making what it called its ‘final’ 6% pay offer last week.

Consultants are already due to strike on Thursday and Friday this week (20 and 21 July) and the BMA said they will now also walk out on 24 and 25 August.

The Government announced a 6% pay rise for doctors on 13 July, saying this was a ‘final’ offer which ‘no amount of strikes’ would change.

Health and social care secretary Steve Barclay said: ‘We’ve made it clear this pay award is not up for negotiation and urge those unions still in dispute with the government to end their strikes immediately.‘

But the BMA said it was ‘another real-terms pay cut’ and warned that strikes would continue, and potentially include ‘other’ doctor groups.

The consultants’ strike action will be based on Christmas Day levels of cover, meaning emergency care will still be provided.

BMA consultants committee chair Dr Vishal Sharma said: ‘This “final offer” and flat refusal to engage in further talks has left us with no option but to continue our action.

‘We have therefore announced further strike dates in August and will announce further dates in due course.

‘The Government must also understand that we will continue to stand up for consultants and, if necessary, are in this for the long haul.’

He added: ‘The Prime Minister says cutting these waiting lists is a priority but then undermines his own policy by showing he doesn’t value those charged with delivering it.‘

A version of this story was originally published by our sister publication Pulse.

NHS consultants in England vote yes for industrial action over pay

27th June 2023

The BMA has secured backing for its plans for NHS consultants to take industrial action on 20 and 21 July 2023.

Nearly nine in 10 (86%) of eligible consultants voted in favour of strike action in the ballot, which saw a 71% turnout. Only consultants who are members of the BMA could take part in the vote.

If the strike goes ahead, it will be the first time senior NHS doctors have gone on strike since 1975.

Their decision will add to the Government’s woes in trying to achieve its targets to reduce the elective backlog, with junior doctors already due to take the NHS’s longest-ever strike action 13-18 July.

‘Repeatedly devalued by Government’

Dr Vishal Sharma, BMA consultants committee chair, said consultants had not taken their decision around industrial action ‘lightly’ but the vote shows ‘how furious they are at being repeatedly devalued by Government’.

‘Consultants are not worth a third less than we were 15 years ago and have had enough. Consultants don’t want to have to take industrial action, but have been left with no option in the face of a Government that continues to cut our pay year after year.’

But he stressed that ‘it is not too late to avert strike action and the Government simply needs come back to us with a credible offer that we can put to our members’.

‘We are simply asking for fairness to ensure that there is a pay settlement that begins to reverse the real-terms pay decline that we have suffered and a commitment to fully reform the pay review process to ensure that it can make truly independent recommendations in the future that take into account historical losses so that we don’t find ourselves in this situation again. But if they refuse, it is with a heavy heart that we will take action next month,’ Dr Sharma said.

He added doctors will ‘prioritise patient safety and continue to provide emergency care, in-keeping with the level of services available on Christmas Day’.

And he said: ‘Consultants are the NHS’s most experienced, highly-skilled clinicians, and are responsible not just for providing specialist care patients, but also leading entire services and training the doctors of the future. The Government can and must fix consultant pay now and for the future. Failure to do so will lead consultants to leave the NHS and the country, or towards retirement before their time.

‘The loss of this expertise would be devastating for services, patients and the future of the NHS.’

Reopening talks on the cards

A Department of Health and Social Care spokesperson said: ‘We hugely value the work of NHS consultants and it is disappointing the BMA consultants have voted to take strike action. Consultants received a 4.5% pay uplift last financial year, increasing average earnings to around £128,000, and they will benefit from generous changes to pension taxation announced at budget.

‘Strikes are hugely disruptive for patients and put pressure on other NHS staff. We’ve been engaging with the BMA Consultants Committee on their concerns already and stand ready to open talks again – we urge them to come to the negotiating table rather than proceeding with their proposed strike dates.

‘We urge the BMA to carefully consider the likely impact of any action on patients.’

The Government has welcomed the news that there will be no further nursing strike action as unions have failed to secure required mandates.

In response, a Government spokesperson said: ‘We hugely value the work of nurses and welcome the end to hugely disruptive industrial action so staff can continue caring for patients and cutting waiting lists.

‘More than one million eligible NHS staff are receiving their pay rise and one-off payments this month, with an experienced nurse receiving over £5,100 in extra pay across last year and this year. We are committed to supporting nurses to continue to progress and develop, including as part of the upcoming NHS Long Term Workforce Plan.

‘We hope other unions who remain in dispute with the Government recognise it is time to stop industrial action and move forward together.’

Radiographers in the UK have also recently been balloted over strike action. The Society of Radiographers (SoR) closed the ballot on 28 June and the results are due in the coming days.

SoR executive director Dean Rogers said: ‘Radiographers and doctors shouldn’t be having to threaten strike action to get the Government’s attention but unless they listen, engage and revisit their 5%, many more will likely be joining us again before the end of the year.’

A version of this story was originally published by our sister publication Pulse.