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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Paul Hamlyn chair of surgery at Imperial College London, has also previously argued that the GP partnership model is out of date and that GP services should be brought ‘into the fold’ to ‘finally complete the NHS’.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.
5th October 2023
‘Serious discussions’ must resume between the Government and doctors to end strike action ahead of winter, NHS England bosses said today.
At this afternoon’s board meeting, NHS England chair Richard Meddings stressed that winter pressures ‘impossible to manage’ if also impacted by strike action.
And chief executive Amanda Pritchard noted talks between the Government and doctors needed to urgently resume.
Following months of strike action, consultants and junior doctors have jointly been striking for three full days this week, with ‘Christmas Day’-level cover.
Mr Meddings told the board that it is ‘simply not sustainable to continue to operate with this amount of disruption’.
He said: ‘There’s simply not enough staff on “Christmas Day cover” days to complete the usual tasks while also dealing with business-as-usual levels of demand.
‘It would be impossible to manage this coming into the winter period. But we will continue of course to do all we can to keep caring for patients, putting them first but we urgently need to see a clear path to resolution and for all parties to work together to do the right thing by patients and to find an agreement to this dispute.’
Ms Pritchard said that the focus of NHS England’s discussions with both unions and Government regarding the strike action continues to be patient safety.
She added: ‘We all want to see serious discussions resume between unions and Government and with winter approaching that cannot happen soon enough.’
The Department of Health and Social Care declined to comment and instead pointed towards a previous statement.
This saw health secretary Steve Barclay urging unions ‘to end their relentless strike action’ and argued that doctors ‘have received a fair and reasonable pay rise – as recommended by the independent pay review body, which we’ve accepted in full’.
The BMA has repeatedly asked the Government to return to the negotiating table, with consultants saying this week that they are willing to involve reconciliation service ACAS and revive strike action discussions.
Yesterday NHS England told the British Medical Association (BMA) in a formal warning letter that ‘cumulative’ impact of doctor strikes are now causing ‘significant disruption and risk to patients’.
However the BMA argued that patient safety is being put at risk due to strike planning failures by NHS England.
BMA council chair Professor Phil Banfield said that the union has always been open to discussing ways to maintain patient safety.
BMA Cymru Wales has announced it will ballot junior doctors in Wales for strike action for six weeks from the 6 November. If successful, it will lead to a 72-hour full walk-out by participating junior doctors in Wales.
This comes following ’the Welsh Government’s failure to make any effort to restore junior doctors’ pay, which has left BMA Cymru Wales with no choice but to enter a trade dispute and ballot for strike action’, it said.
A version of this story was originally published by our sister publication Pulse.
3rd October 2023
The UK health secretary Steve Barclay has announced a £30m fund to speed up adoption of new health technology in the NHS.
Addressing the Conservative Party Conference today, he also announced ‘three new medical schools’.
However, the Labour Party and the BMA both pointed out all three schools already exist and two of them already train medical students.
The new tech fund will be open to applications from ICSs for projects that meet an ‘unmet need’ and bring ‘tangible benefits’ for patients or ‘improve productivity or staff experience’, the Government said.
The funding will be made available this calendar year, with projects expected to complete before the end of the financial year.
In his speech, the health secretary suggested projects could focus on artificial intelligence or cancer diagnosis.
He said: ‘Cutting-edge technology like AI has the potential to transform our healthcare but we need to roll out these innovations faster so that patients receive the benefits as quickly as possible.
‘That is why today I am announcing the creation of a new £30m Health Technology Adoption and Acceleration Fund, enabling clinicians to adopt proven technologies that can improve patient care in their local area.
‘This fund, resulting from a long-term decision by the Government to build a brighter future for the NHS, will provide new tools to help detect cancer sooner, enable people to receive treatment in the own homes and increase productivity.’
On medical schools, the health secretary announced that the new schools will be at the University of Worcester, the University of Chester and Brunel University in Uxbridge, west London.
According to the Government, this will provide a further 205 undergraduate places from September 2024.
Mr Barclay said: ‘I’m delighted to announce today that we are making more than 200 medical school extra places available at universities for next September.
‘Most of these places will be going to three new NHS medical schools, meaning hundreds of additional doctors working on the wards in the years to come.
‘This will help ensure the NHS is set for the future and that patients get the care they need when they need it.’
But Dr Emma Runswick, BMA council deputy chair, said: ‘With more than 10,800 doctor vacancies in England’s hospitals alone, these additional 205 places a year are a drop in the ocean. The health secretary is fooling no one if he thinks this is the answer to the NHS’s medical workforce crisis – while he simultaneously refuses to talk with the doctors we already have.
‘We desperately need to attract and recruit more doctors, but most crucially we need to keep the doctors working in the NHS right now, and to do that we need to ensure they’re valued appropriately. You can’t fill a leaky bucket without plugging holes in the bottom.’
This article was originally published by our sister publication Pulse.
29th June 2023
The UK Government’s latest scheme to increase access to the anti-diabetic drug semaglutide is designed to reduce levels of obesity and related complications. But past evidence suggests it is doomed to fail. Clinical writer Rod Tucker finds out more.
A two-year pilot scheme, backed by investment up to £40m, is to be launched in the UK to increase accessibility to the anti-obesity treatment semaglutide outside of hospital settings.
Obesity is a leading cause of conditions such as cardiovascular disease, diabetes and cancer, and was reported to be a factor in more than one million admissions to NHS hospitals in 2019/20. According to information released by the Department of Health and Social Care, obesity has an annual cost to the NHS of £6.5bn.
On the face of it, the rationale for widening access to the anti-diabetic treatment appears sensible. Any approach that leads to a reduction in the level of obesity should give rise to a commensurate decrease in the number of individuals developing obesity-related conditions and requiring interventions such as knee and hip replacements. If obesity levels drop, so would the waiting list for these complications. Its a win-win situation.
But there are two other relevant considerations. Firstly, does wider access to semaglutide align with current recommendations for the drug, and secondly, how likely is it that the pilot scheme will be successful?
In March 2023, NICE recommended semaglutide as an option for weight management in adults, alongside a reduced-calorie diet and increased physical activity. However, there were several caveats attached to this recommendation.
Firstly, use of the drug was restricted to a maximum of two years and it could only be prescribed at a specialist weight management service. Secondly, patients were required to have at least one weight-related comorbidity and body mass index (BMI) of at least 35.0 kg/m2, although patients could access the drug if they had a BMI of 30.0 kg/m2 to 34.9 kg/m2 and met the criteria for referral to specialist services.
By broadening access to semaglutide, the pilot scheme is therefore at variance to the NICE guidance. While NICE is sponsored by the Department of Health and Social Care, and purported to be independent of the UK Government, it has been argued that the organisation is not, and indeed cannot be, truly independent of the Government.
To date, NICE has remained silent on the Government’s latest initiative, probably because it goes against everything that was outlined in its draft guidance. The Government has argued that its latest scheme is merely a pilot project to explore if and how the anti-diabetic drug can be made safely available outside of a hospital settings. This will happen, it says, alongside NHS England’s work to implement NICE’s recommendations to make this new class of treatment available to patients through established specialist weight management services.
The evidence for semaglutide is convincing, but it is important to acknowledge that the drug only works when used as an adjunct to diet and exercise. Moreover, it is likely to require life-long use despite the two year restriction imposed by NICE. It is now clear that significant weigh re-gain occurs once patients stop taking the anti-diabetic drug, and another study shows how mean body weight increased by 6.9% after cessation of treatment.
A further barrier to the potential success of the pilot scheme is the growing recognition that obesity is a complex condition and that hypothalamic neuro-inflammatory responses play an important role. As a result, obesity management requires a multi-interventional approach.
Commenting on the pilot scheme, the UK health and social care secretary Steve Barclay said: ‘This next generation of obesity drugs have the potential to help people lose significant amounts of weight when prescribed with exercise, diet and behavioural support.’
But how effective is a primary-based weight management service likely to be? An insightful analysis of GP and nurse practitioner habits in response to a mock scenario, makes for interesting reading. Published in 2020, the study found that overall only 24% of respondents would refer patients to a weight management service. The most common response, in over 80% of cases, was to provide either diet or exercise-based advice.
Despite this, evidence from the US offers some hope that behaviour-based weight-loss interventions, either with or without weight loss medications, result in more weight loss than usual care conditions.
The potential for greater access to an effective anti-diabetic weight-loss drug is to be welcomed. Nevertheless, it can only ever serve to address the consequences and not the root causes of obesity. A huge amount of evidence also makes it abundantly clear that obesity is inextricably linked to socioeconomic and demographic factors. Overweight and obesity are far more prevalent in deprived areas, in those of black ethnicity and in the least well educated. In fact, someone living in the most deprived area is nearly twice as likely to be obese as someone in the least deprived area.
With past behaviour seen as the best predictor of future behaviour, the evidence over the last 30 years does not augur well for the current pilot scheme. A recent analysis has shown how obesity policy in England has involved 14 strategies, published from 1992 to 2020, which contain 689 wide-ranging policies. The authors suggested that the continued failure to reduce the prevalence of obesity in England for almost three decades may be due to either weaknesses in the policies’ design, or to failures of implementation and evaluation.
Obesity represents a growing problem, with 25.9% of adults in England obese and 37.9% overweight. Moreover, we live in an obesogenic environment that is influenced by the availability and affordability of foods, together with varying access to opportunities for physical activity. Consequently, it is perhaps too simplistic to label obesity as an individual’s problem: obesity is an environmental problem that requires a wholesale change with regulatory interventions directed at reducing intake of ultra-processed food and acknowledgement of the impact of socioeconomic factors. Such a change requires additional funding, and considerably more that the currently allocated £40m.
Greater access to the anti-diabetic drug semaglutide is unlikely to single-handedly solve the problem of obesity. Nonetheless, if provided through an adequately funded weight management services as part of a comprehensive package that includes behavioural support, access to exercise facilities and nutritional advice, it might have a noticeable effect on levels of obesity and its health-related consequences.
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