How will the election affect the NHS?

The outcome of the general election marks the first Conservative majority Government for 18 years. Despite polls anticipating results between Labour and the Conservatives to be tight, David Cameron’s party achieved a convincing victory. So what effect will a Conservative majority Commons have on the NHS?

Health and social care was one of the key issues addressed during the 2015 general election campaign, and the Conservative Party have committed to spend at least an additional £8 billion on the NHS over and above inflation by 2020 (The Conservative Party, 2015). This is in line with the amount outlined by Simon Stevens in the Five Year Forward View (NHS England et al, 2015) as being required if the NHS is to be sustainable. However, the Conservatives have not yet indicated where this money will come from or how much will come each year.

The Conservatives plan to continue to strive for a truly 7-day NHS, and aim to give all patients access to a GP from 8:00 am to 8:00 pm, 7 days a week by 2020 (The Conservative Party, 2015). They have guaranteed that everyone over 75 years will get a same day appointment if they need one, and have said they will train and retain an extra 5 000 GPs (The Conservative Party, 2015). However, analysis published by the Royal College of General Practitioners suggests that under current systems, patients will have to wait until 2034 for the proposed additional GPs (Rimmer, 2015). The College has estimated that 8 000 more GPs will be needed in England by 2020 to keep up with patient demand, and so an emergency package of measures is needed if this is to be realised (Rimmer, 2015).

Other priorities for the Conservatives include equal priority for the treatment of mental conditions and the need to integrate health and social care systems by joining up services between homes, clinics and hospitals (The Conservative Party, 2015).

The impact for ambulance services of 5 years under the Tories is unclear. However, it is likely that the gradual shift in focus to treat people at home rather than in A&E will see an enhanced role for paramedics. That being said, it will not be easy. While paramedics are well placed to provide additional health services, February saw the profession being added to the shortage occupation list for the first time, as increased pressures brought on by longer hours and growing stress levels have led to many looking for alternative lines of work.

NHS Providers chief executive, Chris Hopson, has argued that until performances and finances are stabilised the NHS cannot transform (Hopson, 2015). Going forward this will undoubtedly be the challenge for the Conservative Government. By addressing these factors as a priority, only then can patient quality of care be ensured.

References

The Conservative Party (2015) Strong leadership. A clear economic plan. A brighter, more secure future. The Conservative Party Manifesto 2015. http://tinyurl.com/q82h3g6 (accessed 1 June 2015)

Hopson C (2015) The new health secretary will face an uphill battle. HSJ. http://tinyurl.com/ovw3j7a (accessed 1 June 2015)

NHS England, Public Health England, Health Education England, Monitor, Care Quality Commission, NHS Trust Development Authority (2014) Five Year Forward View. http://tinyurl.com/kcjenmc (accessed 1 December 2014)

Rimmer A (2015) It will take up to 31 years to deliver number of GPs promised by political parties, says RCGP. BMJ 350: h2472. doi: 10.1136/bmj.h2472

Taken from Journal of Paramedic Practice, published 5 June 2015.

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Government rejects proposed 1% NHS pay rise

Around 600,000 NHS staff will receive a lower pay rise than expected following the government’s rejection of proposals to increase staff pay by 1%.

The independent NHS Pay Review Body recommended a 1% rise across all pay scales but ministers have claimed this as an ‘unaffordable’ cost.

Staff eligible for incremental ‘progression pay’ increases on the Agenda for Change framework, which usually average at 3.4%, will not receive a 1% rise on top of this. However, staff due to receive incremental rise of less than 1% will have them lifted to 1%.

Danny Alexander, the chief secretary to the Treasury, said: ‘We need to continue with public sector pay restraint in order to put the nation’s finances back on a sustainable footing.

‘We are delivering on our commitment to a 1% pay rise for all except some of the most senior public sector workers.’

NHS Employers has defended the decision to curb NHS pay. Chief executive, Dean Royles, said:

‘These are really tough calls for the government to make. We know staff have worked incredibly hard in some very challenging circumstances when the NHS has been subject to exceptional scrutiny. For many staff a pay increase would of course help ease some financial pressures and for others a pay award would be a welcome recognition in a difficult year. We know how tough this decision will feel and how disappointed staff will be.

‘The evidence we gave to the review body said any rise would add to already significant cost pressures. Employers are recruiting more front line staff with no additional money and this is not sustainable. The simple fact is that the decision to have no annual pay increase for those already eligible for increments will help ensure more that staff remain in employment than would otherwise be the case.

‘More than two-thirds of NHS spending is on staff and increasing all staff pay by 1% cent would have cost about half a billion pounds, equivalent to around 14,000 nurses. Even with limiting the increase to staff at the top of their pay scales, employers still face a £150 million pay bill pressure this year. This is bound to have an impact.’

Health unions have reacted furiously to the announcement, with Rachel Maskell, head of health at the union Unite, saying that it will ask its members to consider industrial action over the pay award.

She added: ‘[Jeremy Hunt] is deliberately muddying the waters by trying to imply that the annual increment that staff receive, as they gain more skills to benefit patients throughout their careers, is part of the annual pay increase—it is not. It is despicable that Hunt has adopted such an underhand tactic.

‘The [pay review body’s] role is defunct, if ministers continue to steam roller its copious evidence gathering process which leads to its considered recommendations on pay.

‘Hunt has created a parallel pay universe where 2,400 top NHS bosses are earning more than David Cameron—this is a gravy train for the elite, while nurses, health visitors, paramedics and speech and language therapists are treated with contempt.’

Taken from Journal of Paramedic Practice, published 26 March 2014.

Antimicrobial resistance is a ‘ticking time bomb’

The Chief Medical Officer Professor Dame Sally Davies has announced that global action is needed if we are to overcome the ‘catastrophic threat’ of antimicrobial resistance.

The warning, made in her second annual report, highlighted the lack of new antibiotics discovered in the past two decades.

Despite new infectious diseases being discovered on an almost yearly basis, very few new antibiotics have been developed.

This means that we have limited resources to manage the increasing number of infectious diseases that are ever evolving to become resistant to current drugs.

‘We need to work with everyone to ensure the apocalyptic scenario of widespread antimicrobial resistance does not become a reality,’ said Professor Davies. ‘This is a threat arguably as important as climate change for the world.’

The importance of preserving current antibiotics was also emphasized. Professor Davies argued that in order to retain the effectiveness of existing antibiotics, responsible prescribing must be adhered to.

‘All physicians who prescribe antibiotics have a responsibility to their patients (and public health) to prescribe optimally,’ she said.

To help meet the challenges set out by Professor Davies, the Department of Health is planning to publish a UK Antimicrobial Resistance Strategy.

This five-year strategy will focus on championing the responsible use of antibiotics by ensuring NHS staff have the necessary knowledge, skills and training to prescribe antibiotics effectively.

Professor Davies stressed that governments and organizations across the world, including the World Health Organization and G8, need to realize the seriousness of the problem.

‘If we don’t act now, any one of us could go into hospital in 20 years for minor surgery and die because of an ordinary infection that can’t be treated by antibiotics.’

Taken from Practice Nursing, published 19 Mar 2013.

Why Brains Matter

The Neurological Alliance launched a survey entitled ‘Our Brains Matter’ as part of the 2013 Brain Awareness Week, 11-17 March.

Brain Awareness Week is a global campaign to increase public awareness of the progress and benefits of brain research.

The aim of the Our Brains Matter survey is to develop a clear picture of the experience of being diagnosed with a neurological condition in the UK. With the evidence gathered, the Neurological Alliance will push for improvements in the diagnosis of all neurological conditions.

The Neurological Alliance is the collective voice for 10 million children, young people and adults in England with a neurological condition. It is a membership organization consisting of more than 70 national brain and spine organizations.

The coalition of charities has warned that a ‘legacy of neglect’ is preventing an estimated 12 million people living with neurological conditions in the UK from gaining vital treatment.

According to the Neurological alliance this is due to a lack of specialist knowledge and haphazard services.

‘Around one in six people in the UK will experience a neurological condition in their lifetime,’ explains Arlene Wilkie, Chief Executive of the Neurological Alliance, ‘Yet little is being done to ensure that the NHS is fit for purpose when it comes to responding to these complex conditions.’

Taken from Practice Nursing, published 19 Mar 2013.

LAS improves out of hospital cardiac arrest survival rates

As part of a call to action from health secretary Jeremy Hunt to reduce the number of avoidable deaths in the UK, the Department of Health has published an outcomes strategy on cardiovascular disease (CVD), which will support the NHS and local authorities in delivering improved outcomes for those with or at risk of CVD.

The announcement comes following The Lancet’s recent report on the UK’s health performance, which highlighted that the UK was a long way behind many other countries.

CVD affects the lives of millions of people and is one of the largest causes of death and disability in the UK. However, fast responses to emergencies can save lives and, in some cases, reduce disability.

According to the strategy about 50 000 out of hospital cardiac arrests (OHCA) occur each year in England. Due to a variety of reasons, such as co-morbidity, resuscitation may be inappropriate, and so attempted resuscitation by ambulance services occurs in less than 50% of cases.

However, there is significant variability between ambulance services in rates of successful initial resuscitation (13-27%) and survival to hospital discharge (2-12%) following an OHCA. If survival rates were increased from the overall average (around 7%) to that of the best reported (12%), it is estimated that an additional 1 000 lives could be saved each year.

The strategy revealed that since 2004/2005 the London Ambulance Service (LAS) has improved overall OHCA survival to hospital discharge from a rate of 4% to 11% in 2011/2012. This is as a result of quicker response times; taking heart attack and cardiac arrest patients direct to heart attack centres; and improving bystander resuscitation.

Despite improvement in the LAS, variation in the quality of acute care in other parts of the country mean that much can still be done if patient mortality from CVD is to see considerable change.

The CVD outcomes strategy claims that the NHS Commissioning Board (CB) will work with the Resuscitation Council, the British Heart Foundation and others to promote automatic external defibrillator (AED) site mapping/registration and first responder programmes by ambulance services, and consider ways of increasing the numbers trained in cardiopulmonary resuscitation (CPR) and using automated AEDs.

Taken from Journal of Paramedic Practice, published 14 Mar 2013.

Australia introduces HPV vaccination for boys

Australian schoolboys have begun receiving vaccinations to protect them against cancers and disease caused by the human papillomavirus (HPV).

HPV is a common infection that is associated with cervical cancer and genital warts. It has also been linked with other cancers such as throat cancer, although not as strongly.

‘We’re confident that extending the program to males will reduce HPV-related cancers and diseases in the future,’ said Australian Health Minister Tanya Plibersek.

Following the introduction of the vaccine to girls in 2008 to help reduce the risk of cervical cancer, Australia has become the first country in the world to publicly fund HPV vaccinations in boys.

The action has resulted in organizations such as the Throat Cancer Foundation to urge the UK to follow suit. However, the Department of Health for England has held its ground, saying that due to the lack of scientific evidence, there was no plan to implement the vaccination of boys into the NHS programme.

According to the Throat Cancer Foundation, the vaccine costs as little as £45 per person, and treatment for throat cancer costs the NHS around £45,000 per patient, meaning there is considerable cause for discussion of the topic.

Taken from Practice Nursing, published 18 Feb 2013.