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Take a look at a selection of our recent media coverage:
15th July 2024
The new UK health secretary Wes Streeting has announced an ‘independent investigation’ into the ‘state of the NHS’ to be led by Professor Lord Ara Darzi.
The findings of this ‘rapid’ investigation, which will be published in September, will feed into a new 10-year plan ‘to radically reform’ the NHS, for which patients and staff will be consulted ‘soon’.
Writing for The Sun, Mr Streeting repeated his claim that the NHS is ‘broken’ and said an investigation is needed to ‘diagnose the problem’.
Lord Darzi, a former Labour minister who Mr Streeting described as a ‘one of the NHS’s leading experts’, has been asked to produce a ‘raw and honest assessment’ of the state of the NHS.
The health secretary said the NHS and the Department of Health and Social Care (DHSC) have been ‘instructed’ to share ‘whatever information’ Lord Darzi needs.
Mr Streeting also argued that ‘sticking-plasters’ will not fix the NHS, and rather ‘fundamental reform’ is required.
The 10-year plan will be led by Sally Warren, who will be leaving her position as policy director at the leading health think tank The King’s Fund, to join DHSC.
During his time as health minister, Lord Darzi led an influential national review of the NHS entitled ‘High Quality Care for All‘, which aimed to improve accountability in clinical practice.
He also worked on Labour’s GP ‘polyclinic’ model – known as Darzi centres – which was later scrapped by the Coalition Government in 2011.
One of Labour’s manifesto promises was to trial ‘neighbourhood health centres’, which seem to resemble the Darzi model, with the aim of improving out-of-hospital care.
Lord Darzi, a surgeon who holds the Paul Hamlyn chair of surgery at Imperial College London, has also previously argued that the GP partnership model is out of date and that GP services should be brought ‘into the fold’ to ‘finally complete the NHS’.
In a statement, Mr Streeting promised that the Government ‘will be honest about the challenges facing the health service’.
He continued: ‘This investigation will uncover hard truths and I’ve asked for nothing to be held back. I trust Lord Darzi will leave no stone unturned and have told him to speak truth to power.
‘I want a raw and frank assessment of the state of the NHS. This is the necessary first step on the road to recovery for our National Health Service, so it can be there for us when we need it, once again.’
Lord Darzi said that the ‘first step’ to tackling any health problem is to establish a ‘proper diagnosis’, and that this investigation will help to reinstate ‘quality of care as the organising principle of the NHS’.
‘My work will analyse the evidence to understand where we are today – and how we got to here – so that the health service can move forward,’ he added.
The Royal College of Emergency Medicine (RCEM) has pledged its support to the new Government’s aim of ‘fixing’ the NHS but have warned that ‘efforts must be targeted to where they are most needed‘.
Calling the independent report ‘a step forward for transparency‘, Dr Ian Higginson, vice president of RCEM, said: ‘The health secretary was right, the NHS is broken, and the effects are seen nowhere more starkly than in emergency departments. RCEM has been clearly articulating the real picture for years, and it is refreshing to see a pragmatic and honest assessment of where we are and the scale of the challenge.
He added: ‘To make a significant improvement bed capacity needs to increase, and the beds that we do have need to be used more effectively. People need to be able to leave hospital as soon as they are well enough and there needs to be appropriate social care support there for them when they do.
‘There can be no quick fix in undoing what has been years in the making, but we remain committed to working with the new Government to resuscitate emergency care and restore public confidence in the NHS.‘
The new health secretary has also met with the British Medical Association’s junior doctors committee to reopen talks in a bid to bring an end to strike action.
A version of this article was originally published by our sister publication Pulse.
20th June 2024
NHS dementia services will need to make big changes to identify which patients may be eligible for new disease-modifying therapies such as donanemab and lecanemab, which are likely to be available later this year.
Currently less than 1% of patients in NHS memory clinics had amyloid biomarker testing performed, and this will need ‘urgent’ service development if patients are to access newer treatments once approved.
A retrospective study of 1,017 patients who had attended either memory services or a specialist cognitive service in London found a substantial number of patients could be eligible for disease-modifying therapies if they become available on the NHS.
Of the 517 attending a memory clinic, researchers found that 32% would likely be considered for the drugs, yet in this setting patients did not have access to tests they would need before starting treatment.
In the specialist service where amyloid biomarker tests were available, only 14% of the 500 patients would be potentially eligible for treatment, the researchers reported in the Journal of Neurology, Neurosurgery and Psychiatry.
They noted that in the current set up of psychiatry-led community memory clinics – where most dementia care is delivered – it is extremely unlikely the disease-modifying therapies would be administered.
Their adoption will require additional staff and training across imaging, diagnostics and pathology, and other clinical services, the team from Queen Mary University of London said.
It will also require access to laboratories that can carry out biomarker testing to confirm eligibility, they added.
There is also ‘real potential’ to amplify existing inequities in service access, they noted.
Both donanemab and lecanemab have been reported in clinical trials to slow the progress of Alzheimer’s disease in its early stages. Approval for use on the NHS is expected this summer.
Professor Ruth Dobson, professor of neurology at Queen Mary University of London and consultant neurologist at Barts Health NHS Trust, said: ‘The development of disease modifying therapies for dementia has the potential to drive significant service changes.
‘We have seen the impact of this in [multiple sclerosis] and stroke. It is crucial to understand and plan such changes proactively in order to ensure best care for all people living with dementia, regardless of initial treatment availability and eligibility.’
Study lead, Professor Rimona Weil, consultant neurologist at the UCL Dementia Research Centre and honorary consultant neurologist at the National Hospital for Neurology, said the researchers had worked with clinicians running memory clinics was crucial to get ‘real-world estimates for how many people are likely to be referred for these new drugs for the first time’.
David Thomas, head of policy and public affairs at Alzheimer’s Research UK, added: ‘New Alzheimer’s drugs are finally on the horizon, but for their full potential to be realised, health systems need to be able to offer people with symptoms of dementia an accurate and early diagnosis to find out whether these treatments could benefit them.
‘As this research demonstrates, the NHS is a long way from being able to do this testing routinely.’
A version of this article was originally published by our sister publication Pulse.
4th April 2024
Every hospital trust will be required to have ‘a designated lead for the primary-secondary care interface’ and integrated care boards (ICBs) asked to ‘regularly review progress’, according to NHS England’s newly published ‘2024/25 priorities and operational planning guidance’.
Delayed since December due to funding discussions, the guidance sets an overall priority for the NHS in England over the next 12 months as the ‘recovery of core services and productivity following the Covid-19 pandemic’ continues.
Introducing the guidance, NHS chief executive Amanda Pritchard said despite ‘increasingly mature partnerships in operation at [integrated care partnership], ICB and place level’ the nation’s ‘ageing population, and growing numbers of patients with multiple and complex conditions’, means the NHS and its partners ‘must continue to adapt so that we can help people to live longer, healthier lives’.
According to the guidance, streamlining the patient pathway by improving the interface between primary and secondary care is ‘an important part of recovery and efficiency across healthcare systems’.
By introducing a designated lead for the primary-secondary care interface, it is hoped that trusts will deliver on the four key areas set out in the access to primary care recovery plan and endorsed by the Academy of Medical Royal Colleges: onward referrals, complete care (fit notes and discharge letters), call and recall and clear points of contact.
Commenting on this interface, David Wiliams, head of policy and strategy at NHS Providers, said his organisation is already ‘seeing the advantages’ of leaders of NHS trusts and local health systems ‘working closely with primary care partners to improve how they cooperate to benefit patients’.
And he said this was ‘playing out in a variety of ways as system working matures and care pathways are being transformed, often at a very local level’.
He added: ‘Designated primary care leads will be welcome support in the drive to achieve closer working, but given the pressure of day-to-day operations, trusts and primary care providers will need national support to focus on the long-term to deliver further improvements.’
Improving emergency department waiting times compared to 2023/24 is another core focus of the planning guidance, with a target for A&E staff of a minimum of 78% of patients being seen within four hours in March 2025.
The Royal College of Emergency Medicine (RCEM) had described a previous target of 76% of patients being seen within four hours as ‘unambitious’. On the latest target, RCEM president Dr Adrian Boyle said the ‘small percentage improvements in four-hour access performance are difficult to endorse when there are so many people waiting for 12 hours or longer’.
He also highlighted the incentive scheme for major emergency departments that ‘achieve the greatest level of improvement’ and/or are able to see 80% of patients within four hours outlined in the planning guidance as being ‘potentially divisive’ and uneconomical.
‘We would prefer a quarterly approach to incentivise improved performance, perhaps using the Commissioning Quality Incentive payment system,’ he said.
Dr Boyle did, however, welcome the planning guidance focus on bed occupancy, saying: ‘It is critically important to reduce the dangerous occupancy levels we are currently seeing.’
Dr Boyle noted NHS England data showing that total bed occupancy levels in hospitals across the country reached 95.1% on 20 March 2024.
He said: ‘Overcrowding and patients who are technically ready to go home but haven’t got the right care provision in place, is really adding to the delay problems faced by ambulance staff and we need to ensure that staff in Emergency Departments are able to offer patients the care that they deserve.
“Bed occupancy is still too high and seems to be increasing which is not a good sign that any improvement in that area is forthcoming.’
Nevertheless, the planning guidance outlines an ambition to reduce the number of patients who are still in hospital beyond their discharge-ready date, as well as the length of delay.
It is hoped that continuing to develop services that shift activity from acute hospital settings to settings outside an acute hospital for patients with unplanned urgent needs, supporting proactive care, admissions avoidance and hospital discharge will also be of benefit, the guidance said.
Other priorities outlined in the planning guidance include reaching a 77% faster diagnosis standard (FDS) target for cancer this year as an interim step toward meeting the target of 80% by March 2026, reducing Category 2 ambulance response times to an average of 30 minutes across 2024/25, as well as improving the working lives of all staff and increasing staff retention and attendance through systematic implementation of all actions and best practice made available through the NHS retention hub.
Acknowledging that many of these ambitions will be ‘stretching’ and require ‘a relentless focus on improvement, fewer delays and unnecessary processes’, Ms Pritchard said the guidance ‘should be seen as the floor, rather than the ceiling, of our collective ambition to be a better and more responsive employer’.
Royal Colleges and NHS partner organisations have expressed concerns about how this will work in practice.
Looking at the guidance as a whole, Matthew Taylor, chief executive of the NHS Confederation, called the ambitions ‘very challenging for the health service’.
‘We are concerned that the NHS is entering the new financial year in a worse underlying position, with the risk of further strike action over the next six months… compounded by the financial crisis facing many local councils.’
He also criticised the timing of the publication, saying that while the Confederation understood the impact the wider political context is having on long term decision making, ‘we need to get back to a position where the planning guidance is released months and not days ahead of the new financial year’, and that ‘this short-term approach risks holding back the NHS and with it, the wider health and care system’.
Also picking up on the strikes, Sally Warren, director of policy at The King’s Fund, warned that the plan is ‘built upon an assumption that there will be no industrial action throughout the year despite the fact negotiations are still ongoing’.
She added: ’This means it’s quite possible the Government will need to step in to find additional funding if industrial action continues or new pay deals are agreed, assuming it wants the NHS to deliver on the expectations and targets that have been set out.’
25th March 2024
NHS staff who are black or minority ethnic (BME) face more harassment, bullying and abuse by patients, patients‘ families, the public and other staff members, according to NHS England figures.
Around 30% of BME staff were harassed, bullied or abused by patients, patients‘ families or the public in 2022, compared to 26.8% of white staff. In the same year, 27% of BME staff experienced the same from colleagues, compared to 22% of white staff.
The figures have been released as part of the NHS workforce race equality standard 2023, which looks at how trusts are addressing race and inequalities.
NHS England said there was ‘continued evidence’ of ‘sustained improvement’ since 2016 when the first report was published, with the total number of BME staff at very senior manager level up 61.7% since 2018 (from 201 to 325).
However, it added there was still work to be done. Although the percentage of BME board members increased in all seven integrated care system (ICS) areas of England – in London, the Midlands, North East and Yorkshire, North West and South West – the gap in representation between board and workforce widened because the increase in BME representation was slower than the growth in the wider workforce.
The NHS workforce disability equality standard report 2023 was also published this week, which found that disability declaration rates by NHS staff had improved in 2023 by 19.9%. But, 33.2% of disabled staff reported experiences of bullying, harassment or abuse from patients, service users or the public. Some 16.1% reported this from managers and 24.8% from colleagues.
Health secretary, Victoria Atkins, said: ‘I want to see the NHS recruit and retain brilliant people from all backgrounds. It is important that the NHS at all levels represents the people it cares for, and I welcome progress in appointing more black and minority ethnic staff to senior positions and better representation of disabled people in the NHS workforce.’
Deputy chief executive at NHS Providers, Saffron Cordery, said: ‘Trust leaders remain dedicated to improving working conditions for ethnic minority and disabled staff, but substantial challenges persist, including in relation to supporting career progression and tackling harassment, bullying and abuse.
‘While ethnic diversity in the NHS workforce has increased, the speed at which this is happening at board level, particularly among executives, is not keeping pace with overall diversity of the workforce. This has led to a stark disparity in board representation.’
She added: ‘These report findings, along with the latest NHS staff survey showing ethnic minority and disabled staff are more likely to experience abuse from patients and the public, underline the need for urgent action to ensure staff feel safe.’
The NHS staff survey, published earlier this month, revealed widespread reports of discrimination and sexual harassment by patients and colleagues during the past year.
A version of this article was originally published by our sister publication Healthcare Leader.
21st March 2024
The NHS will face further industrial action from junior doctors between April and September after 98% voted to continue striking.
The BMA’s mandate for industrial action had ended after junior doctors undertook a five-day strike at the end of February – the tenth round in this current pay dispute which began in March 2023.
This new ballot gives the BMA a new mandate between 3 April and 19 September 2024. It also approved the use of ‘action short of strike’, which is when employees continue to work but do not perform some of their duties.
BMA junior doctors committee co-chairs Dr Robert Laurenson and Dr Vivek Trivedi said: ’It has now been a year since we began strike action. That is a year of strikes too many.
‘The Government believed it could ignore, delay and offer excuses long enough that we would simply give up. That attitude has now led to the NHS wasting £3bn covering the strikes. This is more than double the cost of settling our whole claim. And as we see in the results of today’s [20 March] ballot, delaying tactics will not work: doctors are still determined to see their pay cuts reversed, and they are willing to keep striking another six months to achieve that.’
They also called on the Government to come forward with a ‘credible offer on pay’.
‘No doctor wants to be on strike for a second longer than they have to. But it took us 15 years of declining pay to get here’, they added.
Matthew Taylor, chief executive of the NHS Confederation, said the renewal of the mandate was ‘extremely disappointing’.
‘More disruption is the last thing that our members want when they are trying to tackle long waiting lists and improve performance across urgent and emergency care, mental health and community services,’ he said.
‘Health leaders will also be worried about the impact action short of a strike could have on services. The NHS faces wide staffing gaps and, unfortunately, can need to rely on the goodwill of staff to fill vital rota gaps and maintain patient safety. Action such as working to rule could pile immense pressure on to already stretched rotas.’
He called on both the government and the BMA junior doctors committee to restart negotiations to find a solution.
Deputy chief executive of NHS Providers, Saffron Cordery added that the news marks ‘another worrying escalation in this lengthy dispute’.
‘With today’s results underlining the sheer strength of feeling among junior doctors, trust leaders are now facing anxious waits on three fronts with consultants voting on whether to accept their new deal, and specialist, associate specialist and specialty doctors being surveyed on their rejected deal,’ she added.
‘Alongside the nearly 1.5m appointments delayed since industrial action began, strikes are expected to cost the NHS an estimated £3bn. We cannot go on like this. Politicians and unions must urgently find a way to resolve all disputes for the sake of patients, staff and the NHS.’
A version of this article was originally published by our sister publication Healthcare Leader.
1st March 2024
Poorly controlled asthma significantly contributes to greenhouse gas (GHG) emissions, with these patients contributing eight times more excess GHG than those with well-managed asthma, new research has found.
In a first-of-its-kind study, the researchers also found that patients with poorly controlled asthma produce the same quantity of GHG as 124,000 homes each year in the UK.
The researchers – a consortium from the NHS, UK and international universities and AstraZeneca – say that 90% of the excess GHG emissions from asthma care in the UK are the result of inappropriate use of short-acting β2-agonist (SABA) reliever inhalers.
Published in the BMJ journal Thorax, the findings highlight how the improvement of care of people with asthma could substantially reduce carbon emissions and help the NHS meet its net zero targets.
The NHS aims to reduce its carbon footprint by over 80% over the next 15 years and reach net zero by 2045, and better management of asthma could help achieve this goal.
This retrospective cohort study, based on the SABA use IN Asthma (SABINA) I UK study, used anonymised health records of 236,506 people with asthma from the Clinical Practice Research Datalink, collected between 2008 and 2019, to examine the environmental footprint of asthma care in the UK.
Patients were all aged 12 and over, with a validated record of a current asthma diagnosis and current asthma at 12 months prior to baseline.
GHG emissions were retrospectively analysed by measuring carbon dioxide equivalent (CO2e) for asthma-related medication use, healthcare resource utilisation and severe exacerbations during follow-up of patients with asthma for both well-controlled and poorly controlled asthma at base level.
Well-controlled asthma was categorised as fewer than three prescriptions of SABA reliever inhalers per year and no episodes where symptoms became severe.
Poorly controlled asthma included patients who needed three or more SABA prescriptions per year and experienced one or more episodes of severe symptoms, which involved either a course of oral corticosteroids and any general practice and outpatient visits within 10 days of hospitalisation or emergency department visit.
Asthma was poorly controlled in just under half (47.3%) of the patients analysed. At baseline, patients with poorly controlled asthma versus those with well-controlled asthma received a greater number of prescriptions for SABA, inhaled corticosteroid (ICS) monotherapy and ICS in conjunction with long-acting bronchodilator inhalers.
Scaled to the national level, the overall carbon footprint of asthma care in the UK was 750,540 tonnes CO2e/year, with poorly controlled asthma contributing excess GHG emissions of 303,874 tonnes CO2e/year.
GHG emissions were eight times higher on average for a person with poorly controlled asthma than those with well-controlled asthma.
One outcome of inadequate asthma control is the increased use of SABA reliever therapy. The analysis shows that 90% of the excess GHG emissions resulted from inappropriate SABA use in patients with poorly managed asthma.
Due to worsening symptoms, the remaining excess emissions resulted from healthcare utilisation, such as GP or hospital visits.
Although SABAs provide immediate bronchodilation, they lack anti-inflammatory activity and contribute minimally to achieving asthma control. In addition, SABA prescriptions of more than three canisters per year are associated with an increased risk of exacerbations, asthma-related mortality and increased use of healthcare resources.
The researchers stated: ‘Our study indicates that poorly controlled asthma contributes to a large proportion of asthma-care related greenhouse gas emissions with inappropriate SABA use emerging as the single largest contributor.’
The Global Initiative for Asthma no longer recommends SABA inhalers are used alone as the preferred reliever for acute asthma symptoms.
The researchers concluded that efforts to implement evidence-based treatment recommendations for asthma patients and curtail inappropriate SABA use could result in substantial carbon savings for the NHS.
In November 2023, it was announced that a low-carbon salbutamol metered-dose inhaler that could reduce greenhouse gas emissions from inhaler use by around 90% was advancing to phase 3 trials in the first half of 2024.
16th February 2024
Wireless technologies aiming to help free up staff time, strengthen connectivity in emergency departments and ambulance bays and improve patient care are being trialled across seven NHS trusts.
Part of NHS England’s Wireless Trials programme, the trials aim to provide organisations with the capability they need to deliver the challenging digital ambitions set out in the NHS Long Term Plan.
Each of the seven trusts involved will benefit from a share of NHS England’s £1 million funding, as well as advice and guidance and the opportunity to collaborate with like-minded organisations, NHS England said.
Examples of best practice from successful trial sites will also be captured and shared across the wider NHS, it added.
One of the triallists is Manchester University NHS Foundation Trust, which will trial an innovative approach of combining satellite and cloud-based wireless solutions to enhance connectivity across its 10 hospital sites and wider community services.
Commenting on their plans, Dan Prescott, group chief information officer at Manchester University NHS Foundation Trust, said: ‘As one of the country’s largest NHS trusts, it’s essential that we can provide continuous patient care with minimum disruptions. With the Wireless Trial we’re aiming to create a reliable, fast and secure network access solution to address unexpected connectivity issues, even in areas of poor-connectivity.
‘This is vital in supporting key initiatives for our staff and giving our patients the best possible care.’
Mid Cheshire Hospitals NHS Foundation Trust will use the funding to install wireless trackers on medical equipment and hospital beds, which allow real-time monitoring and location tracking so that staff can easily find what they need, when they need it. The trial is expected to be completed by summer 2024.
Dylan Williams, chief information officer at Mid Cheshire Hospitals, said: ‘Piloting this cutting-edge technology is an exciting opportunity for us as we drive forwards with the creation of a new Leighton Hospital Campus in Cheshire.
‘At our Trust, the money will fund an innovative project that tracks medical equipment at our hospitals. Initially, we’ll trial it on infusion pumps. This will support efficient maintenance of the equipment and ensure clinical staff can quickly and easily locate the pumps when needed.
‘One of our key ambitions for the New Hospital Programme is to embrace digital technology and the benefits it can bring for our patients and staff. Trialling this project now allows us to make significant progress with one of the advancements that we can expect to be commonplace at Mid Cheshire Hospitals in the future.’
The Princess Alexandra Hospital NHS Trust will also install wireless trackers on medical equipment and hospital beds in a similar trial.
Another project run by Sussex Community NHS Foundation Trust will introduce a new app that allows staff to take observations on tablets and smartphones by patients’ bedsides, reducing the time spent typing up patient notes and freeing up more time to spend with patients.
A trial at the Countess of Chester NHS Foundation Trust will wirelessly link modern diagnostic devices with the trust’s electronic patient records system, speeding up assessment time for patients.
Both the North West and the East of England ambulance services trusts will roll out improved wireless connections in A&E and ambulance areas, ensure faster transfer of essential patient care data from ambulances to hospitals.
Commenting on the new trials, Stephen Koch, executive director of platforms at NHS England, said: ‘I have been impressed with the innovative ideas coming from the system and we are delighted to be able to award this funding to the successful trialists to develop new or improved wireless solutions for the NHS.
‘We’ll be monitoring the outcomes of the trials and are very hopeful that a number of these will be able to be scaled more broadly across the health and social care system saving clinical time, improving patient care and saving money for the system.’
Previous wireless trials included the development of the ‘Find and Treat‘ service at University College London Hospitals. This uses high-tech tools and software to provide real-time remote diagnosis and referrals on board a mobile health unit to support vulnerable, homeless, and high-risk people in the city.
Another trial led to South London and Maudsley NHS Foundation Trust becoming the first 5G-connected hospital in the UK.
Applications for the next series of wireless trials will open later in 2024.
Introducing a national programme of weekend high-intensity theatre lists to reduce backlogs and offering hospital consultants protected time for research are among the recommendations outlined in a major new report.
In its ‘Report into the state of health and social care in Britain today’, the Times Health Commission called for high-intensity theatre lists to be launched once a month in 50 hospitals to get through a week’s worth of planned operations in a day and create seven-day surgical hubs.
It also outlined incentivising NHS staff to take part in research, and put the case for research to their patients, by giving 20% of hospital consultants and other senior clinicians 20% protected time for research.
These two recommendations form part of the report’s 10-point plan for the Government to transform the NHS.
To support the plan’s development, the Times Health Commission visited hospitals, care homes, GP surgeries and research laboratories in the UK, Japan, Denmark, Israel, Ireland and Spain to source examples of best practice.
The commissioners then established three core principles to underpin the report and recommendations, which they said are ‘pragmatic, practical, deliverable and could be taken up by any political party or government’.
The principles are rebalancing the health system away from hospitals and a putting greater emphasis on prevention and community care, reforming social care to reduce overcrowding in hospitals and give patients better support, and enabling the system to become more personalised and predictive through the use of technology.
The Commission called for doctors, nurses and midwives who stay in the NHS for three years to have their student debt cut by 30%, rising to 70% for those still working after seven years, and 100% after 10.
It said the health services must become a ‘much better employer’ in ways that go ‘beyond health settlements’, including affordable staff canteens, night transport and on-site childcare.
The requirement for junior doctors to rotate across the country must also end to better balance work and family, it said.
Other recommendations included creating digital health accounts or ‘passports’ for patients to book appointments; order prescriptions; view records, test results or referral letters; and contact clinicians.
And establishing a National Care System with the aim of giving everyone the right to appropriate support locally and in a timely fashion. This should be delivered by a mixture of the public and private sectors, the report said.
Chair of the Times Health Commission Rachel Sylvester said: ‘Despite its huge challenges, there is enormous cause for optimism for our health service. The NHS and social care system must seize the extraordinary opportunities on offer in the modern digital world to empower patients, liberate clinicians, improve services, drive efficiencies and create a healthier Britain. Other countries have done it and so could we.’
Commenting on the report, Royal College of Physicians president Dr Sarah Clarke said: ‘At a time when the NHS faces significant demands, we welcome the Times Health Commission’s report. Its 10-point plan places an important focus on increasing and supporting the medical workforce, fostering an environment where existing staff can flourish, and taking an important preventative approach to tackling health inequalities and ill health.
‘We also welcome the inclusion of social care within the report’s recommendations for reform – social care must be staffed and funded as an equal partner to the NHS to deliver optimal care for patients.’
Also responding to the report, Professor Philip Banfield, British Medical Association council chair, welcomed its focus on staff retention and supported the student loan write-off recommendation.
However, he said: ‘The Commission sadly fails to make the obvious recommendation of restoring doctors’ pay, which would have a real impact on retaining clinicians.
‘Without this, any meaningful hopes of addressing the near record-waiting lists will be dashed. Indeed, accelerated weekend theatre lists are all well and good, but the premium required to fund such activity risks detracting from essential investment elsewhere; doctors are already exhausted after working beyond their hours all week, already spread too thinly.’
Professor Banfield added: ‘There is a lot to unpack and consider in this report and its recommendations, but ultimately the ability to improve the state of the country’s health and services is bound by the Government’s will to act, and crucially, invest. This change must come from listening to the doctors and colleagues that give their all on the front line every day. We are the solution, not the problem.’
Matthew Taylor, chief executive of the NHS Confederation, who was a commissioner involved in the report, also called for greater Government funding to align with the report’s recommendations.
He said: ‘The NHS is recognised as one of the most efficient healthcare systems in the developed world, but we know that more can be done to improve productivity, and health leaders and their teams are always looking at ways to generate even greater efficiencies.
‘One of the crucial ways that this productivity challenge can be addressed is by providing the NHS with the capital investment it needs, which has not been covered in this comprehensive report. Specifically, in England, capital funding needs to increase to at least £14.1bn annually, a £6.4bn increase from the current level of £7.7bn. This is vital if we are to increase productivity and reduce waiting lists.’
In January 2024, a surgical workforce census report found that over half of the UK surgical workforce face problems accessing theatres, which is contributing to long waiting times for hospital treatment and excessive workloads.
11th December 2023
A new report from the British Psychological Society (BPS) is urging the Government to commit to further long-term funding for NHS staff mental health and wellbeing services, calling it ‘fundamental‘ for workforce retention, the delivery of the NHS Long Term Workforce Plan, and protecting patient care.
The BPS ‘Learning from the NHS Staff Mental Health and Wellbeing Hubs‘ report highlights the need for standards for staff mental health provision, amid concerns that staff struggling with their mental health could face a postcode lottery to access the support they need from a dwindling number of NHS Staff Mental Health and Wellbeing Hubs.
Set up in February 2021 to provide health and social care staff with rapid access to mental health support, ring-fenced Government funding for NHS Staff Mental Health and Wellbeing Hubs ended in March 2023, with integrated care systems (ICSs) either identifying short-term interim funding for their Hub for a defined period of time, or closing them.
The report highlights a data analysis from the Nuffield Trust showing six million sick days recorded for NHS staff due to anxiety, stress, depression and other psychiatric illnesses in 2022, with sickness absence associated with a higher likelihood of staff leaving the NHS.
And the same Nuffield analysis revealed that a consultant missing three days of work for mental health reasons is 58% more likely to leave three months later.
Further figures outlined in the BPS report showed demand for NHS Staff Mental Health and Wellbeing services is increasing.
Data from one hub recorded 404 people registering for one-to-one support between July 2023 and September 2023 – a 65% increase on the same period in the previous year during which 245 referrals were made – with one in five of those accessing one-to-one support identified as senior leaders.
BPS says its report aims to support health and care leaders make ‘crucial decisions‘ about future investment in local mental health and wellbeing services for their teams.
It cites evidence of the cost benefits for investment in mental health and wellbeing that shows an investment of £80 per member of staff in mental health support can achieve net gains of £855 a year through savings from absenteeism and presenteeism.
Noting ‘more than 121,000 unfilled jobs across the NHS in England today‘, Saffron Cordery, deputy chief executive of NHS Providers, said: ‘Heavy workloads and huge pressure on stretched services are leading to lots of staff feeling worn out. The effects of financial pressures on trusts and the cost of living crisis on staff amid the longest period of industrial action in the history of the NHS’ history have compounded problems of high staff turnover.‘
As a result, the report makes a series of recommendations, including that:
Dr Roman Raczka, president-elect of the BPS, said: ‘The ambitious measures set out in the NHS Long Term Workforce Plan are not a quick fix.
‘Existing and future staff members deserve to work in an environment that gives them the support they need, to provide the safe, high-quality care they as health and care professionals are proud to give.
‘Put simply, NHS and social care employers cannot afford to ignore the mental health needs of their workforce, if they wish to create a system that’s fit for the future.‘
30th October 2023
Waiting lists for elective NHS care will reach a high of eight million people next summer if current trends continue, regardless of strike action, according to new analysis.
A Health Foundation report has projected the future elective backlog based on four different scenarios – none of which achieve the expectations of the Government’s elective care recovery plan.
If current activity growth continues at 7.4% a year and there are no more strikes, the list will peak at around eight million in August 2024 before dropping to 7.8 million by the end of the year, the think tank has found.
However, in another predicted scenario, if activity growth remains the same and strike action continues, the resulting waiting list will be around 180,000 higher.
The Health Foundation also found that strike action already taken by consultants and junior doctors has increased the waiting list by roughly 210,000, which equates to 3% of the overall list size.
Latest NHS figures show that as of August, 7.75 million people were waiting to start their first treatment, which is a record high.
At the start of last year, NHS England published the elective care recovery plan which reiterated the goal to deliver around 30% more elective activity by 2024/25 than before the pandemic, and set out an expectation to see the waiting list reducing by March 2024.
And in January this year, Prime Minister Rishi Sunak pledged that NHS waiting lists would fall, making it one of his five key priorities for 2023.
However, even in the Health Foundation’s ‘better-case scenario’, with hospital activity growth increasing by a third, the waiting list will only fall to below 7.2 million by the end of next year, which is the same level as when the PM made this pledge.
The report has also found that the monthly number of GP referrals to treatment, having returned to pre-pandemic levels, is in fact increasing at a faster rate than before.
According to the authors, this is down to patients who had put off seeking treatment during the pandemic now coming forward.
Although NHS secondary care is also increasing the number of treatments delivered each month, it cannot keep pace with the number of referrals.
Director of data analytics at the Health Foundation Charles Tallack said industrial action has only ‘directly resulted in a small increase’ to the waiting list, despite Government rhetoric.
Mr Tallack said: ‘Ministers have been quick to blame industrial action for the lack of progress in reducing the waiting list but the roots of this crisis lie in a decade of underinvestment in the NHS, a failure to address chronic staff shortages and the longstanding neglect of social care.
‘The pandemic heaped further significant pressure on an already stressed system but waiting lists were already growing long before Covid.’
He also said that returning waiting times to 18 weeks will be ‘very challenging’ but ‘entirely possible’ if the Government focuses on policy action and investment.
BMA chair of council Professor Philip Banfield said the new analysis shows that doctors ‘are not the ones to blame for the shameful backlog in NHS elective care’.
He said: ‘While there is no doubt that industrial action has had an effect on the ability to reduce waiting lists – something that could have been avoided entirely if the Government had come to the table willing to listen to doctors in the first place – it pales in comparison with a decade of failure of policy on the NHS from the top.
‘The Government needs to rethink its priorities: now is not the time to abandon patients in ideological stand-offs with the doctors who can materially improve the situation.’
Shadow health secretary Wes Streeting said the report ‘blows out of the water the Conservatives’ attempts to blame doctors and nurses’ for the NHS crisis.
‘Rishi Sunak’s failure to stop the strikes has only made a terrible situation worse, leaving even more patients waiting in pain and discomfort, unable to live their lives to the full,’ Mr Streeting added.
In August, the Prime Minister claimed that long NHS waiting lists were down to striking doctors, saying the industrial action is the reason patients have to wait for appointments.
And earlier this month, NHS England formally warned the BMA, saying strikes are now causing ‘significant disruption and risk to patients’.
The Government has recently agreed to meet with the BMA Consultants Committee in the hope of finding a resolution to the current dispute, which will be the first formal talks between the two parties since May.
A version of this story was originally published by our sister publication Pulse.
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