Mental health campaigners have offered cautious support to a government plan intended to improve mental health services.
Cuts to services have let to what has been described as “dangerously high” bed occupancy rates and waiting times.
Meanwhile, there have also been major problems in the sector with staff retention.
And the Royal College of Nursing has been critical of government proposals, asserting that they appeared “not to add up”.
But the Health Secretary Jeremy Hunt has announced plans to create over 20,000 new posts at a cost of around £1.3 billion.
This will result in more trained nurses, therapists, psychiatrists, peer support workers and other mental health professionals, while efforts to retrain and retain mental health staff will also be significantly increased.
“As we embark on one of the biggest expansions of mental health services in Europe it is crucial we have the right people in post – that’s why we’re supporting those already in the profession to stay and giving incentives to those considering a career in mental health. These measures are ambitious, but essential for delivering the high performing and well-resourced mental health services we all want to see,” Hunt commented.
However, the Royal College of Nursing doubts whether there is sufficient time and funding in order to train enough new healthcare professionals.
Janet Davies, the RCN’s chief executive, believes that training must begin within the next few weeks if the nurses proposed by the Health Secretary are to be delivered adequately.
“The government’s policies appear not to add up. It is clear the government will need to work hard just to get back to the number of specialist staff working in mental health services in 2010. Under this government, there are 5,000 fewer mental health nurses and that goes some way to explaining why patients are being failed. The NHS needs to see hard cash to deliver any plans.”
Hunt also indicated his intention to recruit 2,000 further members of staff to work with children and young people suffering with mental health problems.
While the Health Secretary also announced plans to increase the number of nurses working within the NHS.
“But we are expanding the nursing workforce: we have nearly 6,000 more nurses on the front line than we had in 2010. We want to expand it further. One of the reasons we have been able to expand the workforce to date is because, with a limited budget and a very difficult economic situation, we have shown pay discipline.”
But the chief executive of the mental health charity Mind, Paul Farmer, despite welcoming the plan, suggested that the quality of mental health services being delivered has consistently declined over recent years.
“A damaging lack of foresight in workforce planning in the past has led us to where we are now, with a significant gulf between what’s in place and what’s needed to deliver good quality care. Cuts to mental health services in recent years have led directly to posts being axed and have taken their toll on morale, which has led to valued staff leaving mental health in frustration or burn-out.”
A new report suggests that 40% of GPs are considering quitting the profession in order to retire within the next five years.
The review was conducted by the Royal College of GPs, and increased concerns that many doctors are dissatisfied with changes promised by the Department of Health.
Its Five Year Forward View initiative was intended to increase the number of family doctors by around 5,000, yet the NHS faces a decline in this number rather than the escalation promised.
Support staff were also promised by the Five Year Forward View, with general practice widely considered to be in a parlous state at present.
Increased patient demand is causing a strain on diminishing resources, while the long opening hours demanded by the government can also be particularly challenging, particularly for small surgeries and practices.
Indeed, a survey of GPs conducted in the completion of the report discovered that many GPs continue to struggle under the existing workload.
In this context, four-in-ten state they are unlikely to be working within the NHS system in just five years’ time.
Responding to the data, the Royal College of General Practitioners asserted that the findings indicate that the GP profession could reach breaking point unless urgent action is taken.
Professor Helen Stokes-Lampard, chairwoman of the RCGP, summed up the mood of the organisation.
“We know we’re only one year into a five-year plan, but GPs are desperate – they really, truly want to deliver the best possible care for patients, but the pressures they are under are unbearable.”
Stokes-Lampard believes that the situation with training in the NHS is only exacerbating the situation.
“It takes at least three years in speciality training for new doctors to enter the workforce as independent consultant GPs, so whilst it’s fantastic that more foundation doctors are choosing general practice this year, if more people are leaving the profession than entering it, we’re fighting a losing battle.”
And Dr Richard Vautrey, the British Medical Association’s GP committee chairman, also spoke out on what he perceives to be a workforce crisis.
“Despite the GP workforce shrinking again last year, the Government has continued to promise 5,000 extra GPs to patients. It is time to admit that this pledge is now unachievable. In order to create a stable GP workforce, the Government must expand the number of GPs entering the profession, and urgently address the underlying issues, particularly the unsafe workload pressure, behind the recruitment and retention crisis in general practice.”
NHS England Chief Executive, Simon Stevens, and Secretary of State for Health, Jeremy Hunt, top the line-up of leading national speakers at this year’s Health and Care Innovation Expo 2017 – the most significant health and social care event of the year.
Delegates will have the chance to hear the latest on the progress of NHS England’s Five Year Forward View, which is leading the transformation of patient services in key areas such as cancer care, mental health and emergency and urgent care.
The high profile speaker list includes the Chief Nursing Officer for England, Jane Cummings, and NHS England’s National Medical Director Professor Sir Bruce Keogh.
Others speaking on behalf of NHS England include Dr Arvind Madan, Director of Primary Care, Professor Chris Harrison, National Clinical Director for Cancer, and Claire Murdoch, National Director for Mental Health.
The programme covers the full breadth of the NHS, local government and social care to include Sir Andrew Dillon, the Chief Executive of the National Institute for Health and Care Excellence; Duncan Selbie, Chief Executive of Public Health England; Andrea Sutcliffe, Chief Inspector of Adult Social Care for the Care Quality Commission; Richard Kemp CBE, Deputy Chair of the LGA’s Community Wellbeing Board; Mike Thompson, CEO of the British Pharmaceutical Industry and Professor Matthew Cripps, National Director for NHS Right care, NHS England.
The theme for this year’s event is ‘Collaboration to implement the NHS Five Year Forward View across health and social care’.
As well as the two main ‘Future NHS’ and ‘Innovate’ stages, there will be four smaller theatre stages and four feature zones focussing on Transformation of Care, Urgent and Emergency Care, Primary Care and Digital Health.
‘Pop-Up Universities’ will feature again this year, showcasing the very best in innovative care, treatment and commissioning from across the NHS, local government and social care, as well as giving in-depth information on the latest developments in individual areas of the health and care sector.
Workshops are led by some of the most senior and experienced professionals in England.
Early-bird delegate rates are still available for Expo 2017 with NHS, local government and public sector staff able to secure complimentary access.
Regular updates on the event can be acquired via the Twitter handle @ExpoNHS.
Three of the world’s top universities will provide virtual masterclasses in leadership and digital as part of a comprehensive programme to provide NHS staff with the right skills to drive digital innovation.
The NHS Digital Academy led by Imperial College London’s Institute of Global Health Innovation in partnership with Harvard Medical School and The University of Edinburgh will open for applications in September.
Considered part of the NHS’ wider technology plan to simplify access to care online or otherwise, the academy is intended to ensure that hospitals are taking advantage of improvements in digital technology.
It will support the existing work underway via the Building a Digital Ready Workforce National Information Board programme, delivered in partnership by NHS Digital, Health Education England and NHS England.
The academy is also notable for being a virtual organisation.
It will also provide expertise for clinicians and health managers in digital technology.
Rachel Dunscombe, Director of Digital for Salford Royal NHS Foundation Trust, a partner in the initiative, has been appointed the Academy’s Chief Executive.
It is currently anticipated that 300 candidates will pass through the NHS Digital Academy, each spending up to 12 months studying part-time.
Health Secretary Jeremy Hunt proclaimed the academy to be a major development.
“If the NHS is going to have world-class IT systems we need a major programme to spread global best practice – and this links three of the best universities in the world to do just that. The Academy will ensure the next generation of NHS leaders is well equipped with the most exciting innovations that deliver the best care available to patients everywhere.”
While Matthew Swindells, National Director of Operations and Information at NHS England, outlined the ethos of the initiative.
“We want the NHS to be a world leader in the use of digital technology helping to drive improvements in patient care and to make our organisations more efficient. This pioneering academy will provide healthcare leaders with the right skills to tackle some of the most challenging problems facing the NHS.”
And Rachel Dunscombe, CEO of the Academy and Director of Digital for Salford Royal NHS Foundation Trust, suggested that the new arrangement would offer major opportunities for both healthcare organisations and professionals.
“This is an amazing opportunity for us to act as a catalyst for the CIOs and CCIOs equipping them with the skills and leadership to safely digitise the NHS. I am delighted to be part of the Digital Academy and feel privileged to be able to be at the helm of accelerating the digital health profession. This unique collaboration of partners will provide the system leadership needs highlighted by the Wachter review.”
Representatives of BMA Scotland have warned that the latest figures published by the National Records of Scotland on alcohol-related deaths make it essential that efforts to tackle the harms of alcohol misuse are redoubled.
The figures show that in 2016 there were 1,265 alcohol-related deaths, an increase of 10% on the previous year and the highest annual total since 2010.
Chair of BMA Scotland Dr Peter Bennie expressed his concern on the matter.
“These latest figures showing a worrying increase in alcohol-related deaths last year make clear the scale of the damage caused by Scotland’s relationship with alcohol.”
Bennie also suggested that more must be done to address the issue of problem drinking.
“It underlines why as a country we need to redouble our efforts to tackle the harms caused by alcohol misuse, and why we need the Scottish Government’s coming alcohol strategy refresh to include the kind of wide-ranging measures the BMA and other alcohol campaigners recently called for, including action on marketing and availability.”
The chair of BMA Scotland also suggested some possible measures required to address the situation.
“Chief amongst these though is the need for minimum unit pricing, a policy that big alcohol producers have spent far too long delaying and trying to prevent and which must be implemented as swiftly as possible once the legal process finally ends.”
A major Scottish health board has entered into a partnership with Orion Health.
The Golden Jubilee National Hospital is piloting a Patient Portal from Orion Health, that could lead to improvements in the way it engages with patients.
A national resource for Scotland, the Golden Jubilee is helping to redefine the concept of the public hospital, with a vision of “leading quality, research and innovation” for NHS Scotland.
Initially, 40 pulmonary hypertensive patients attending the Scottish Adult Congenital Cardiac Service (SACCS) were invited to participate in the pilot.
SACCS, based at the Golden Jubilee, supports patients living with congenital heart disease.
The Portal will be rolled out to more patients following successful completion of the two-phase pilot at the Clydebank hospital.
This collaboration has resulted from a strategic partnership between the Golden Jubilee and Orion Health, which has provided a Clinical Portal for the hospital since 2011.
Sally Smith, Head of eHealth at the Golden Jubilee, suggests that this new initiative will have a positive impact on healthcare in Scotland.
“As a national resource for NHS Scotland, the Golden Jubilee is continually looking for new and innovative ways of improving the services we provide to our patients. With a vision of leading quality, research and innovation, we are delighted to be leading the way with Patient Portal, which is the first step in allowing patients to get more involved in the care they receive.”
Smith also explained how Scottish residents will be able to access this information.
“Patients will be able to access valuable information about their condition and can share this with relatives, carers, or other clinicians to improve the care they receive.”
By accessing the Patient Portal, patients will be provided with a summary of their most up to date clinical records and related hospital appointments allowing them to share this information with other clinicians.
The Patient Portal will deliver efficiencies, improve patient experience and potentially reduce the number of tests and investigations that patients need to undergo.
“In the next phase of the pilot planned for later this year, patients will be able to upload their own information and complete documents, such as follow-up questionnaires. It is hoped that by providing the patients with access to online questionnaires prior to and after surgery, we will further improve the service for this group of patients,” the aforementioned Smith added.
Colin Henderson, VP EMEA, Orion Health commented on the new arrangement as well.
“We have established a strong and successful strategic partnership with Golden Jubilee National Hospital thanks to our work on the development of their Clinical Portal. It is exciting to have been able to take that to the next level with the development and launch of the Patient Portal – and it is particularly exciting to be partnering with Golden Jubilee on this initiative given their national reach and strong innovation credentials.”
Henderson suggested that many more agreements of this nature will emerge in the coming years.
“We expect to see many more healthcare organisations developing services that use technology to strengthen engagement with patients and populations over the next few years.”
BMA Scotland has responded to Audit Scotland report, ‘NHS workforce planning’; a critical document outlining the future of the NHS in the nation.
Chair of BMA Scotland Dr Peter Bennie suggested that the BMA’s view on staffing was vindicated by the document.
“This latest report from Audit Scotland highlights what we have been saying for some time – there are serious workforce challenges facing the health service in Scotland which must be tackled by the Scottish Government as a matter of urgency.”
Bennie expanded on this assertion, and outlined some of the major healthcare issues in the region.
“Rising vacancy levels, a lack of effective workforce planning and an ageing staff profile is putting a significant burden on the existing workforce already dealing with the stress of a rising workload which is not being adequately resourced. Ongoing uncertainties for NHS Scotland staff from EU countries over Brexit compound the problems.”
The chair of BMA Scotland suggested that the report outlines fundamental problems with the NHS in Scotland.
“The report recognises long-term workforce planning has not been effective. It also highlights responsibility for NHS workforce planning is confused by multiple programmes and levels of response which makes it more difficult to ensure that the right mix of staff will be able to respond to the needs of a changing service where the impetus is to deliver a shift towards more community-based care.”
Bennie also believes that recruitment will get harder in the foreseeable future.
“The difficulties in recruiting and retaining the medical staff we need to provide high quality healthcare for the people of Scotland are well documented. Consultant vacancies have increased from 3.6% in 2011/12 to 7.4% in 2016/17. These unfilled posts mean doctors are trying to bridge gaps in the service which ultimately undermines the quality and safety of patient care.”
And the chair also outlined the competition that the Scottish healthcare system faces from other countries.
“The NHS in Scotland faces competition in a global market when it comes to attracting doctors to work here and we are steadily losing ground. In the face of a 14% real terms pay cut over the last five years there are now over 400 unfilled consultant posts in Scotland, with half of these jobs lying empty for over six months.”
According to Bennie, this problem is further exacerbated by NHS policy.
“This is compounded by the fact that some NHS boards choose to employ consultants on contracts which do not allow for adequate time to keep up to date, to teach, and to improve and develop services. BMA Scotland has been calling on the government to improve these contracts in order to address the recruitment and retention issues. The government must be prepared to recognise and reward the investment of at least a decade that goes into training secondary care doctors.”
Finally, Bennie pointed out that there are serious flaws in the data currently collated by the Scottish healthcare authorities.
“Vacancy levels for staff and associate specialist doctors in Scotland’s hospitals are not even measured, and there are significant gaps in the junior doctor workforce. The high level of long term vacancies is a clear sign that the Scottish Government is not getting to grips with the crisis in the recruitment and retention of NHS staff and action is needed now to make Scotland an attractive place for doctors to train and work.”
As of 31st December 2014, the total number of NHS Scotland staff in post was 137,511.9 whole time equivalent (WTE) – an increase of 1.8% in a year.
The figures, released by ISD Scotland, show that under the current government the NHS Scotland workforce has grown by over 8%, with 10,450 more WTE staff.
This includes an additional 2,315.7 WTE qualified nurses and midwives working in the NHS under this Government – a rise of 5.6% to a new record high level of over 43,000 WTE qualified nurses and midwives.
A new ambulance response system will see all 999 calls subjected to new target times.
Plans announced by NHS England will ensure that the severity of patients’ conditions will directly impact upon response from the emergency services.
Call handlers will also be provided with more time in order to decipher what action is appropriate.
And new targets for ambulances to deal with the most seriously ill patients will be brought in, with an average time of seven minutes set as a benchmark.
Timing will only stop when the most appropriate response arrives on scene, as opposed to the first.
Mandatory targets are also being brought in for response times to 999 calls, abolishing the green rating that today currently receive.
This process can often result in lengthy queueing for 999 callers.
NHS England will also begin tracking the times from 999 calls to hospital treatment for heart attacks and strokes, “where a prompt and appropriate response is particularly critical”.
As a result of the new initiative, targets will be set for 99% of eligible heart attack patients to receive definitive treatment within one hundred and fifty minutes, and the same proportion of stroke patients to receive appropriate management within one hundred and eighty minutes of the 999 call being lodged.
NHS England believes that the new target should be achieved within the next few years, while data collection will begin immediately.
Trials of the planned changes have been subject to a study carried out by Sheffield University, which deemed them ‘safe’, NHS England noted.
NHS England national medical director Sir Bruce Keogh suggested that the new initiative will have a positive impact on the ambulance service and the way 999 calls are handled.
“These changes, together with ambitious new clinical standards for heart attack and stroke patients, will end the culture of ‘hitting the target but missing the point’. They will refocus the service on what actually counts: outcomes for patients.”
While Royal College of Emergency Medicine president Taj Hassan welcomed the plans, indicating that the new approach should have a positive impact on response times.
“Response times will be more appropriate according to the patient’s need, and trials have suggested that ambulances could arrive up to three minutes quicker to the most serious incidents – time which can make the difference between life and death.”
This latest scheme is an attempt to reduce the number of patients suffering difficulties while waiting for ambulances, with recent evidence indicating that this undesirable tendency is increasing.
Skills for Health, Health Education England and Skills for Care have announced a new Framework to support person-centred approaches for the health and social care workforce.
This approach, outlined in the Five Year Forward View, puts people, families and communities at the heart of health, care and wellbeing.
It encourages people to speak with staff about what is important to them, helping to develop a shared understanding of what matters to them.
The new framework, commissioned by Health Education England, helps workers communicate meaningfully both verbally and non-verbally, tailoring the care and advice they give to suit peoples’ needs.
The framework was informed by health and social care experts and people who are experts by experience, drawing on existing person-centred approaches and applying them to today’s health and care landscape.
Engaging in a meaningful way with people and communities is often part of their intrinsic motivation for healthcare workers.
This is also seen through practices like health coaching, motivational interviewing, co-production and care and support planning.
However, it is often less clear how best to develop the workforce to enable them to put person-centred approaches into practice and to create sustained behavioural change, which is the purpose of this framework.
John Rogers, Chief Executive of Skills for Health suggested that the new framework will bring many positive benefits.
“This is a really important piece of work and we were delighted to be commissioned by Health Education England to lead on its development and work alongside Skills for Care. The health and social care sectors have an opportunity with the new framework to create more personalised services, where individuals are actively included in decisions regarding their treatment and care and the way that care is delivered.”
Rogers also explained the advantages of focusing on people with the new approach.
“Building on existing person-centred approaches the use of the framework has the potential to further develop and improve the responsiveness of the care that is offered and the way that it is experienced as well as the importance of a shared workforce around populations. I’m very proud that Skills for Health is able to play a part in that.”
While Ged Byrne, Director of Education and Quality (North) for Health Education England was also positive about the new initiative.
“We recognise the importance of making sure that people feel included and in control over their circumstances and that their contact with the providers of their treatment and care is meaningful and constructive. We were delighted to work in collaboration with Skills for Health and Skills for Care to develop the new framework to try and make it easier for the workforce to develop genuine partnerships with people and families.”
Byrne also explained how the new approach will improve healthcare in the NHS.
“The approaches outlined will help effectively plan, design and deliver care based on a person’s individual needs, giving them confidence to take actions to improve their own health and wellbeing.”
Sensely has won a prestigious award celebrating the very best of innovation in healthcare in collaboration with the West Midlands CCGs.
At the West Midlands Academic Health Science Network (WMAHSN)’s second annual Celebration of Innovation Awards, the Industry Collaboration Award was given for the successful introduction of the Ask NHS App and its integration with the West Midlands NHS 111 Service.
Around 300 people from across the region’s NHS, industry, academia, third sector and patient population gathered at the Hilton Metropole at Birmingham’s NEC on 20 July to see the accolade awarded.
107 entries were submitted across the 12 categories, which were assessed by a panel of experts to choose the eventual winner.
Sensely won the Industry Collaboration Award for the Ask NHS mobile app.
Ask NHS is a mobile app that provides full technical integration with the West Midlands NHS 111 Clinical Assessment Service, the NHS National Directory of Services (DoS), EMIS Web and NHS Choices.
The Ask NHS app currently provides a fast and convenient digital access point to the NHS, giving patients in the West Midlands on-demand access 24/7.
Dr Christopher Parker, Managing Director of the WMAHSN, commented on the result.
“We are absolutely delighted that Sensely won the Industry Collaboration Award. It was so challenging to pick out the winners from such a strong field. Every judge was in agreement that all the submissions showed an astonishing breadth of scope or approaches that were truly innovative and able to transform patient care, provide solutions to significant challenges or break down barriers across our region. It was truly inspiring to be involved in judging the entries.”
While Rachael Ellis, Chief Officer for Integrated Urgent Care, NHS West Midlands, spoke on the mobile app as well.
“We are delighted to now offer our patients of the West Midlands access to Healthcare through the Ask NHS mobile app. Patients across the region can now download the app to assess their symptoms and in the event further Clinical Advice is required then they will be navigated through to our local 111 service. The CCGs are committed to developing digital access to care for our patients. We are delighted our work so far has been recognised by the West Midlands Health and Science Network.”
And Dr. Ivana Schnur, Co-Founder and Chief Medical Officer at Sensely, naturally welcomed the award.
“Sensely is thrilled to have won this year’s Industry Collaboration Award. It is wonderful to receive an award recognising our collective efforts. This award is a testament to our collaborative approach and I want to thank NHS West Midlands and our industry partners for making Ask NHS a success. The Ask NHS app is setting the industry standard on how to enable access to appropriate and quality healthcare, and deliver innovation into the hands of patients.”