Controversy Reigns Over New Prescription Plans

New plans intended to prevent GPs from prescribing drugs available over the counter, with the intention of saving the healthcare system in the region of £200 million, could deny vulnerable patients critical access to medication.

This is the view of some of the most prominent doctors working within the healthcare system.

NHS England had previously announced a plan to “drive out wasteful and ineffective drug prescriptions”.

But a consultation on the new scheme suggests that it will have minimal clinical value, while saving an absolutely trivial amount of money for the taxpayer.

The consultation called for homoeopathy to be phased out, while there should also be limits on prescribing drugs for minor self-limiting conditions, such as cough mixtures, cold treatments, eye drops, laxatives and sun creams.

But both GP leaders and patient charities have been critical of the new policy.

Simon Stevens, NHS England chief executive, had launched the scheme, praising the NHS for its efficiency, but also indicating that more must be done to improve this aspect of the healthcare system.

“The NHS is probably the world’s most efficient health service, but like every country there is still waste and inefficiency that we’re determined to root out. The public rightly expects that the NHS will use every pound wisely, and today we’re taking practical action to free up funding to better spend on modern drugs and treatments.”

Yet Dr Andrew Green, GPC prescribing lead, suggested that the new policy could be discriminatory.

“GPs have a contractual duty to prescribe drugs that their patients need, and pressure must not be placed on them to act in a way that may contravene those regulations. Where there are clinical reasons that drugs should not be provided on the NHS, such as for co-proxamol or homeopathic substances, then these should be added to the “blacklist” which formally prevents NHS supply.”

And Don Redding, director of policy at National Voices, also asserted that financial circumstances must be taken into consideration.

“Whilst some treatments are available to purchase over-the-counter, that does not mean that everyone can afford them. The risk is that the NHS would be saying that it will not support poor people to treat their kids’ head lice, or to manage complications such as persistent constipation or the vulnerability of their skin to damaging sunlight.”

Redding went on to query the way that procurement is being conducted.

“NHS England point out that some of these treatments can be bought over-the-counter at a cheaper price than the NHS can prescribe them. That raises questions about NHS procurement and negotiations with industry. It is not a problem to pass on to the poorest patients.”

 
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Patients to Benefit from £325 Million Investment in NHS Transformation Projects

Health Secretary Jeremy Hunt and NHS England boss Simon Stevens have announced £325 million of capital investment for local projects that will help the NHS to modernise and transform care for patients.

Speaking at the King’s Fund, Mr Hunt and Mr Stevens gave the green light to local capital investment schemes in 15 areas of the country, with the largest sums being used for urgent care in Dorset, surgery in Greater Manchester and cancer care in Cumbria.

Patients will see this investment deliver faster diagnosis for conditions like cancer, easier access to mental health care, expansion of A&Es, shorter waits for operations, and more services in GPs surgeries.

This round of funding will support Sustainability and Transformation Partnerships (STPs) across the country, with plans including:

In Greater Manchester, up to £50m will be made available to help hospitals deliver significant improvements in urgent and emergency care by concentrating services in four hub sites across the city, expected to save around 300 lives each year in general surgery alone.

In Cumbria, £30m – £50m will be used to improve access to chemo and radiotherapy by establishing a brand new cancer centre, complete with new equipment at Cumberland Infirmary in Carlisle.

In Derbyshire, up to £30m will be invested to create an ‘Urgent Care Village’ at the Royal Derby with GP services, a frailty clinic and mental health services to ensure patients receive the right care in the right place, first time, and avoid going to A&E unnecessarily.

This initial tranche of funding has been targeted at the strongest and most advanced schemes in STPs.

All plans have been developed locally.

The funding was secured in the Budget in March when the government also committed to make further capital investment available in the forthcoming Autumn Budget.

Health Secretary Jeremy Hunt suggested that the investment will play a key role in the NHS going forward.

“This funding will support strong local plans to help the NHS modernise and transform care for patients. A measure of success of these transformation partnerships is that people can see and feel improvements being made in their local area – there are already excellent examples of this across the country and this money will allow them to go further and faster.”

And NHS England Chief Executive Simon Stevens also acclaimed the new financial arrangement.

“Today we’re firing the starting gun on the first wave of major service upgrades and care redesign which will benefit people living in counties, towns and cities across England. For patients it’ll mean easier GP appointments, modern A&Es, and better cancer and mental health care. For staff, we’re putting our money where our mouth is in backing these practical plans developed by doctors, nurses and local NHS leaders.”

Stevens also indicated the intention of the healthcare authorities to extend this approach still further.

“This is the first down payment of much needed investment in modern equipment and NHS facilities, with more promised in the Autumn and beyond. Today is proof positive that when you back the NHS with investment, both patients and taxpayers see the practical benefits.”

The strongest STPs have performed well across indicators in three broad areas: hospital performance, patient-focused change and transformation.

 
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Vautrey Elected Chair of BMA’s GP Committee

The well-known healthcare executive Dr Richard Vautrey has been elected chair of the BMA’s GP committee for England and the UK.

Leeds-based Vautrey will immediately begin working in his new position.

Vautrey previously served as deputy under the previous two GPC UK chairs, after a prestigious career working within the General Practitioners Committee.

Indeed, Vautrey has being a long-standing member of the organisation, and previously acted as the committee chair.

This position became available after the exit of Dr Chaand Nagpaul, following his election as chair of the BMA council.

Vautrey continue to practice medicine in Leeds, and is currently the LMC assistant secretary for the region.

The new chair has also been a member of the GPC for 16 years, having previously served for four years as the deputy to Nagpaul.

Vautrey had lost out in the final round of the 2013 chair election, and was deputy to previous chair Dr Laurence Buckman.

The eminent medic had also previously worked as a negotiator under Dr Hamish Meldrum’s chairmanship of the GPC before becoming deputy chair under Dr Buckman.

Vautrey also sits on the BMA and RCGP councils, and is generally hugely active within the healthcare system.

After initially winning the vote for GPC England position, Dr Vautrey was later appointed unopposed to lead for the UK.

The incumbent expressed his understanding of the magnitude of the role, and outlined his determination to make a positive difference in his new position.

“I am truly humbled and honoured to be elected as chair of the BMA’s GP committee for England. At such a crucial time for the future of general practice there can be no greater privilege or responsibility than to be asked to lead our great profession. I know there is much to do to deal with the workload pressures, resolve the workforce crisis and improve the morale of GPs but I firmly believe that GPC, working with LMCs, can turn this situation around and will enable a brighter future for general practice.”

One of the first jobs for Vautrey to address will be the impending industrial action that is currently being balloted by the GPC.

The GPC has asked GPs to indicate whether they would be prepared to take part in a mass closure of patient lists in protest over the ongoing GP crisis, with the BMA also supporting this notion.

There is also a challenging climate in general practice currently, with numerous authoritative organisations agreeing that this critical aspect of the healthcare system is both underfunded and understaffed at present.

This has led many to describe the current situation as a crisis.

 
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NHS Set to End Prescription of Homeopathic Medicine

The NHS has suggested that doctors should cease prescribing homeopathic medicine.

Simon Stevens, NHS England’s chief executive. asserted that “at best, homeopathy is a placebo and a misuse of scarce NHS funds which could better be devoted to treatments that work”.

Although the amount of money spent on homoeopathy is minimal at present, less than £100,000, the recommendation of the healthcare authorities is to phase it out completely.

Homeopathy utilises highly diluted doses of natural substances that some believe help the body to heal itself.

But there has been criticism of this controversial form of medicine, and some healthcare professionals assert that it ultimately does more harm than good.

Indeed, recommendations set out in a consultation document suggest that there is a “lack of robust evidence of clinical effectiveness” to supports the implementation of homoeopathy, calling on GPS to cease from prescribing it to patients.

“Often patients are receiving medicines which have been proven to be ineffective or in some cases dangerous,” the document states, noting there are often “more effective, safer and/or cheaper alternatives”.

Regardless of the effectiveness or otherwise of homoeopathy, it must be stated that the amount currently spent on it within the NHS system is so trivial as to be almost completely meaningless.

Indeed, 1.1 billion prescription items were signed off by doctors at a cost in excess of £9 billion in the most recent financial year; meaning that homoeopathy accounts for around 0.01% of the overall prescription budget.

New national guidelines outlined 18 treatments that should generally not be prescribed to patients from hereon in.

Other treatments that could soon be banned by the NHS include herbal treatments, lidocaine plasters, omega-3 fatty acids and unlicensed use of the painkiller co-proxamol.

Stevens went on to suggest that the new policy is intended to improve the efficiency of the healthcare system.

“The NHS is probably the world’s most efficient health service, but like every country there is still waste and inefficiency that we’re determined to root out. The public rightly expects that the NHS will use every pound wisely, and today we’re taking practical action to free up funding to better spend on modern drugs and treatments.”

Professor Helen Stokes-Lampard, chair of the Royal College of GPs, cautiously supported the move, while also asserting that eliminating some items currently available on prescription risks alienating some of the most vulnerable people in society.

“We know that a number of treatments are of little or no value, and are at best a placebo. We also know many other medications are available very cheaply over the counter and are much more readily obtainable than when they first became available on prescription, and both GPs and the public should be mindful of this. But imposing blanket policies on GPs, that don’t take into account demographic differences across the country, or that don’t allow for flexibility for a patient’s individual circumstances, risks alienating the most vulnerable in society.”

 
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Practices in East London to Benefit from More Regular Payments

A new contract is set to benefit practices in East London, with more regular payments being received by the surgeries via the overarching federation.

Tower Hamlets CCG has agreed a proposal to contract £5 million of local enhanced services with the GP Care Group.

This federation currently comprises the thirty seven practices active in the borough, and has been involved in the collaborated delivery of enhanced services in the region for some years.

The scheme is contracted through a network of four to five practices, with the model informing national policymakers’ plans to deliver more at-scale working.

This new arrangement will see the federation contracted by the CCG, with the intention of reducing transactional burdens on both practice networks and commissioners, while also streamlining the overall process.

While the total amount of funding received will not change, the way payments are proffered will be altered.

This previously occurred on a quarterly basis, but the new arrangements will see this switch to a monthly approach.

It is asserted that this will reduce the strain on practices to reconcile information and arrange payments, ultimately reducing the number of payment irregularities resulting.

GP Care Group chief executive Chris Banks states that a wide range of integrated services within the region will emanate from “each network looking at the management of its own incentive scheme and submitting and monitoring returns”.

“It’s really a consolidation of what was already there and trying to streamline it into one organisation,” Banks commented. “It’s potentially a move towards an accountable care system, with providers taking on more of the management of the contract.”

Despite the implementation of the new system, it has been announced that targets and key performance indicators will continue to be reviewed in the normal manner.

Negotiation between the LMC and CCG in the region will be involved in this process, while cashflow will be managed by the Federation.

No change to total overall funding is anticipated at this time.

Meanwhile, the authorities have announced that key performance indicators are to be reviewed on a quarterly basis, with a reconciliation for adjustments being implemented annually.

The aforementioned Banks believes that the changes will have minimal impact on the day-to-day working of individual practices.

Potential streamlining will come from consolidation of management work, such as data collection and cash flow, currently carried out at network level, releasing resources back into the system.

While responsibility for staffing services will continue to lie with practices, the CCG has said the new arrangement will enable ‘practices to share workforce ‘.

The CCG has also said the plan will allow for a more population-health approach to providing services.

 
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New Report Calls on Performance Payments for Pharma Companies

A new report suggests that pharmaceutical companies should be paid by the NHS depending on how effectively their products ultimately treat patients.

This approach is advocated by the Social Market Foundation, with the organisation asserting that drugs which satisfy a particular criteria should be made eligible to pass through a new purchasing scheme.

The Social Market Foundation believes that this would make medicines available for patients more rapidly.

Based on this new suggestion, the NHS would collaborate with the pharma company in question to jointly agreed on health outcomes to be achieved.

Other issues to discuss could include the basis on which manufacturers of the drugs will be paid, against certain performance yardsticks.

However, the Social Market Foundation also acknowledges that it is essential for safeguards to be built into the process, in order to protect smaller pharmaceutical and biotechnology companies.

With the financial climate of the NHS likely to be increasingly challenging in the coming years, such innovative attempts to make drug purchasing more efficient are almost requisite.

Yet Mike Thompson, chief executive of the Association of the British Pharmaceutical Industry, commented at an event earlier this year that patients in territories search as Germany and France are approximately 700% more likely to obtain a newly-launched medicinal product.

Clinical trials in the UK are already under threat, and this is only likely to be exacerbated by the Brexit process.

Meanwhile, policies intended to achieve outcome-based pricing are being increasingly embraced by both the pharmaceutical industry and the NHS.

Manchester health authorities have mooted paying companies for drugs based on how well they work, with several major players in the pharmaceutical industry having expressed support for the notion.

The Social Market Foundation has particularly cited Italy as a country implementing the approach suggested with considerable success.

And researchers, Nigel Keohane and Kathryn Petrie, said that as the NHS pursued efficiency savings of £22bn over five years, “how we procure medicines is too often left out of the equation”, despite the fact that £16.8bn was spent each year on treatments.

A shift to outcomes-based reimbursement would allow the purchase of medicines to be refocused on “value for money over the longer-term,” they argued.

Any model adopted “should be designed with simplicity in mind — to send clear signals to investors and to retain diversity in the market where small providers can participate fully,” according to the foundation.

The report, funded by Novartis, also included suggestions on how to protect smaller drug companies from competition difficulties.

 
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BMA Confirms Two Candidates for Chair Position

As the British Medical Association seeks a replacement for the outgoing GPC chair Dr Chaand Nagpaul, the organisation has confirmed that two candidates are currently being strongly considered.

No further GPs have chosen to put themselves forward ahead of a major vote on the appointment.

The two candidates understood to be vying for the post are current acting GPC chair Dr Richard Vautrey and current GPC executive team member Dr Mark Sanford-Wood, both of whom will be a extremely familiar to all healthcare professionals.

Members of the BMA’s GP committee will vote to elect a successor to Nagpaul, after a process in which candidates are not permitted to campaign publicly.

Nagpaul has been a general practitioner in Stanmore since 1990, and is stepping down as GPC chair after being elected chair of the BMA.

In addition to this BMA duties, Nagpaul is a BMA Council member, a member of its Political Board, and GPC member on the BMA Public Health Committee and Consultants Committee, as well as being Honorary Secretary of his local BMA Division.

Dr Vautrey has served as deputy to two GPC chairs – Dr Nagpaul and his predecessor Dr Laurence Buckman.

The Leeds GP was also a negotiator under Dr Hamish Meldrum’s chairmanship of the GPC and has been a GPC member since 2001.

Devon GP Dr Sanford-Wood had been a GPC member for five years when he was appointed to the GPC executive team last year.

Both candidates have spoken out strongly about the crisis facing general practice.

Vautrey spoke strongly on the matter at the BMA annual representative meeting in Bournemouth earlier this year.

While Dr Sanford-Wood wrote ahead of this year’s LMCs conference in Glasgow that there was no margin for error in delivery of support for general practice promised in the GP Forward View.

The significance of this position cannot be underestimated, as it is undoubtedly one of the most important within the healthcare system in Britain.

Nagpaul was ranked as the 25th most powerful person in the English NHS in December 2013, and in a list of the 100 top clinical leaders in 2014.

The aforementioned Porter, meanwhile, has been a strong critic of government policy towards the NHS.

In December 2013 he warned the British Medical Association that “the financial outlook is dire. The NHS is struggling just to keep pace. A growing and ageing population, public health problems like obesity, and constant advances in treatment and technology are all contributing to push NHS costs well above general inflation. The numbers overall are so bad that if the NHS was a country, it would barely have a credit rating at all.”

 
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BMA Document Suggests List Closures Would be Particularly Effective

Several prominent GP leaders have thrown their weight behind the proposed industrial action that is currently being balloted on by the British Medical Association.

A letter is currently being circulated among general practitioners, which argues that this approach is “the best choice to cause maximum disruption for government, but minimal harm to patients”.

BMA deputy chair Dr David Wrigley, chair of BMA London regional council Dr Gary Marlowe, GPC members Dr Jackie Applebee, Dr Louise Irvine, Dr Stephanie deGiorgio, Dr Zoe Norris, GP Survival chair Dr Matt Mayer, and LMC representative Dr Susie Bayley have all signed the letter in question.

The indicative ballot currently being undertaken by the BMA questions practices on whether they would be prepared to temporarily suspended new patient registrations or apply to local commissioners for formal list closure.

This industrial action is intended to heap pressure on the government, at the time when there is a huge amount of discontent and discourse regarding the climate of general practice.

LMC representatives agreed the measure at the annual conference in Edinburgh.

And it is particularly deemed to be a response to what is considered to be a fundamental failure of NHS England’s GP Forward View to deliver adequate resources to frontline services.

With the ballot closing on 10th August, the GPC will ask the BMA council to review the results and consider a formal ballot on the subject.

This new conflict is just the latest in a series of industrial action that has been carried out by healthcare professionals in response to government policy.

Advice published by GPC last week alongside voting instructions warned that practices could face breach notices if any action is deemed a breach of contract.

But the letter advises that list closures can be allowed under the terms of the existing contract if they are carried out on the grounds of patient safety.

“Any action by medical professionals is only done with a heavy heart. In advising practices to consider list closure, our representatives are clear that this is a way of causing maximum disruption to the government’s plans for the NHS, registering our disdain at their failure to adequately fund general practice, whilst causing no harm to our registered patients,” the letter argues.

They text of the letter goes on to encourage GPs to ask patients to provide support for the action with petitions and letters to MPs.

“Our patients are the strongest weapon we have in fighting for general practice. Tell them what you are doing and why,’ it says. It adds that the risk to patients is greater if GPs do not take action to stop the collapse of the service. ‘If this list closure happens nationwide however it causes a significant increase in workload for NHS England, as well as public embarrassment to the government”.

 
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New £3.4 Million Radiology Training Department Announced in Wales

A major academy intended to train radiologists and imaging professionals has been announced in Wales.

£3.4 million of funding has been invested in the project by the Welsh government

And the new National Imaging Academy for Wales will be based in Pencoed, Bridgend.

It is hoped that it will be fully operational by the mid-point of 2018.

Health Secretary Vaughan Gething announced the plan, indicating that the academy will “play an important role” in the training of radiologists, increasing the number available to the Welsh healthcare system.

Specialist training will be provided by the new academy, with partnerships being struck with the existing provision for training at hospital sites throughout Wales.

State-of-the-art workstation suites, simulation training and lecture theatres have all been earmarked for the new initiative.

While consultant radiologists from across Wales will deliver the seminar involved, also supervising trainees on imaging studies.

This will include information on the interpretation of X-rays, CT and MRI scans.

While the initial focus of the academy will be on training radiologists, the programme will eventually be extended to include radiographers, sonographers and other professionals involved in imaging.

Although the Welsh healthcare system has been successful in recruiting and training more radiologists in recent years, the fact that 42% of professionals in this niche are over the age of 50 means that further training is essential.

It is notable that Britain has one of the lowest proportions of radiologists of any European nation.

There are seven radiologists per 100,000 people in the UK, as opposed to a European average of 12 per 100,000.

This is reflected in the fact that UK survival rates for cancer, particularly lung cancer, are among the worst in Europe.

There have also been increases in demand for radiologists in Britain in general, and Wales in particular.

Commenting on the issue, clinical lead for the academy, Dr Phillip Wardle, consultant radiologist at Cwm Taf University Health Board, suggested that the new plan will have a massively positive impact on the treatment of cancer in Wales.

“The academy will enable a significant increase in the capacity of radiology training, emulating successful academy models in other parts of the UK,” Wardle commented.

And the aforementioned Gething stated that radiologists and imaging workers were “crucial” in helping medical and clinical staff to deliver the best care.

“The new academy will play an important role in allowing us to increase the number of trained radiologists in the Welsh NHS to ensure a sustainable, high-quality workforce for the future”.

It is also hoped that the academy can become a keystone for research on cancer in Wales.

 
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Biggest Reorganising of Ambulance Service in 40 Years Announced

A major reorganisation of the ambulance service will fewer 999 calls classified as a life-threatening.

The shake-up is considered the largest in 40 years of this critical aspects of the healthcare system, with the aim of reducing the number of incidents requiring a particularly rapid response.

NHS England has approved the new approach, with ministers signing off the new arrangement.

It is presumed that the new guidelines will result in approximately 8% of callouts being classified as requiring the quickest response from ambulances.

This is a massive reduction from approximately 50% currently.

And the authorities conclude that the majority of these incidents are in fact not particularly serious, and could be delayed until paramedics arrived on the scene.

NHS bosses suggest that the new approach will enable ambulances to respond to the sickest people and most serious cases with more rapidity.

They claim that the targets being used are “blunt” and “dysfunctional”, meaning that too many ambulances are dispatched to meet these targets rather than dealing with patient appropriately.

Medical experts have supported this change in policy, after a pilot scheme dealt with 14 million emergency calls over the last 18 months.

Evaluation by Sheffield University discovered that the new initiative will enable 999 calls to be dealt with more swiftly.

Prof Keith Willett, of NHS England, asserted that one of the problems with the current system was that crews were being unnecessarily dispatched to “stop the clock”.

“This has led to the inefficient use of ambulances, with the knock-on effect of hidden waits,” Willett explained.

It is expected that it will be possible to deal with 90% of calls within 15 minutes as a result of the new policy.

College of Paramedics chief executive Gerry Egan indicated that he was “fully supportive” of the move.

“It is vital to patient care that paramedics are targeted to the most appropriate patients,” Egan commented.

And Juliet Bouverie, of the Stroke Association, also suggested that the new initiative should be beneficial for patients.

“Under the current system, the first responder to a stroke patient could be on a motorbike – but this vehicle can’t transport the patient to hospital meaning they have to wait even longer for an ambulance to arrive. By allowing ambulance call handlers a little more time to determine what is wrong with a patient, it ensures that stroke patients can be identified and the right vehicle sent out immediately to get the patient to a stroke unit.”

 
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£86 Million Government Support for Medical Breakthroughs Announced

The Parliamentary Under Secretary of State at the Department of Health, Lord O’Shaughnessy, has revealed a new package of support worth over £85 million, intended to assist British businesses with developing medical innovations.

It is then hoped that the technological breakthroughs will be utilised within the NHS system.

The funding can be considered the first step in the implementation of recommendations made in the Accelerated Access Review.

This document was intended to ensure that patients gain access to innovations in medical care more rapidly.

The cash stream is being provided jointly by the Department for Business, Energy and Industrial Strategy (BEIS) and the Department of Health.

And £56 million of funding is being provided by the Industrial Strategy Challenge Fund, with £30 million siphoned from existing Department of Health budgets.

It is believed that this initiative will have a particularly strong influence over the ability of small and medium-sized enterprises to test and ultimately deliver new healthcare technologies in the NHS system.

Additionally, the rapidity with which such technologies can be delivered from the laboratory to a real-world of setting will also be improved by this new approach, according to the government.

The Department of Health has already broken down how the funding will be distributed, with £39 million available to Academic Health Science Networks (ASHNs), £35 million for Digital Health Technology Catalyst for innovators, up to £6 million to support SMEs in gathering evidence they need through real-world testing; and a £6 million Pathway Transformation Fund.

It is hoped that collectively this will have a real impact on the way that technology is delivered within the NHS.

“The Government’s ambition is that NHS patients get world-leading, life-changing treatments as fast as possible. That can’t happen unless we support medical innovation and tear down the barriers – like speed to market and access to funding – that can get in the way, especially for SMEs,” Lord O’Shaughnessy commented.

And the Ethical Medicines Industry Group believes that the new initiative represents a positive step.

“We will continue to work with the Government to find ways to make significant improvements in patients’ access to medicines,” chairman Leslie Galloway com themented.

Dr Richard Torbett, executive director of Commercial Policy at the ABPI, suggested that the new investment for AHSNs is “an important first step in pulling industry and the health service together to realise the Review’s ambition. Turning the rest of the AAR’s recommendations into reality now relies on a full, positive Government response to the Review – and an effective Life Sciences Industrial Strategy.”

The AAR, which was developed in partnership with the Wellcome Trust, made a total of 18 recommendations that could propel a step change in access and uptake of innovation in the country.

It is hoped that the government will respond to this before the end of the calendar year.

 
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90% of GPs Believe NHS Should Fund Indemnity

Around 90% of GPs believe that the NHS should fund the cost of indemnity, according to an authoritative survey.

Indemnity costs are proving to be an increasing difficulty in this critical part of the healthcare system, while evidence also suggest that NHS claims related to clinical negligence are escalating.

Indeed, in the most recent financial year, the NHS shelled out around £1.7 billion on this issue.

Meanwhile, the MDU – the leading medical defence organisation in the UK – has warned that GPs “simply cannot afford” professional indemnity as costs continue to rise higher.

And a poll conducted by the organisation discovered that 88% believed that the NHS should fund indemnity costs, as is currently the case for hospital doctors.

Official figures published by NHS Resolution indicate that there was a 15% increase in clinical negligence claims in the most recent financial year.

And the figure of £1.7 billion has doubled since the 2010/11 financial year, with around 40% of this figure invested in legal costs.

Dr Matthew Lee, MDU professional services director, believes that indemnity is one of the most serious issues facing the healthcare system and its workers.

“The spiralling cost of claims is something society cannot afford and neither can our GP members, who pay for increasing costs via their professional indemnity. We are already seeing large GP claims heading towards settlement at £15-20m. If GPs aren’t supported, many won’t be able to pay the increased indemnity costs. There would be a crisis in the GP workforce that which would leave patients at risk.”

Lee called on the authorities to address this issue with direct action.

“The government needs to act fast to protect GPs from further indemnity cost increases as it is facing a looming crisis. GPs clearly want the same arrangements for NHS indemnity their hospital colleagues enjoy.”

While Emma Hallinan, director of claims at the MPS, indicated that a legislative solution to this problem is a necessity.

“Legal reform is required to strike a balance between compensation that is reasonable, but also affordable – this includes the introduction of a limit on future care costs based on a tariff agreed by an expert group and fixed recoverable costs for claims up £250,000 to stop lawyers charging disproportionate fees.”

Hallinan also suggested that the indemnity issue could impact on the NHS system as a whole.

“While the report does not cover GP claims, the challenges posed by the rising costs of clinical negligence affect the healthcare system as a whole. We recognise the pressure this places on our GP members and this is why we have launched our Striking a Balance campaign – to tackle the root of the problem.”

 
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