News review – September 2023

04 September 2023

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NR_NHS workforce plan_HALF PORTRAITA record number of doctors, nurses, dentists and other healthcare professionals will be trained as part of the first NHS long-term workforce plan, published in June. The plan is backed by an initial £2.4bn to fund additional education and training places over five years on top of existing funding commitments. By 2031/32, the plan aims to: double medical school training places to 15,000; increase the number of GP training places by 50% to 6,000; and almost double the number of adult nurse training places, with 24,000 more nurse and midwife training places a year. Supported by improved retention measures, the plan claims the health service could have ‘at least an extra 60,000 doctors, 170,000 more nurses and 71,000 more allied health professionals in place by 2036/37’. The government has also committed to refresh its workforce plan every two years. Apprenticeships will feature in new training plans, with 16% of all training for clinical staff offered through apprenticeships by 2028.

Analysis by the Health Foundation, however, has raised concerns about the capacity for universities and healthcare providers to meet the needs of so many new clinical students as part of the workforce plan. The thinktank has predicted capacity challenges with classroom and clinical placement elements, as well as trainer/educator numbers, with such a sharp rise.

The NHS in England has been rocked by a historic series of strikes by clinicians at every level over the past nine months. In August, junior doctors undertook their fifth round of strikes since the industrial action began. This follows a five-day strike in July, the longest of its kind in NHS history. Consultants have also held multiple strikes and have voted for more to come, including their longest yet scheduled for 2-4 October. According to the BMA, both groups’ decision to strike was motivated by the breakdown of talks with the government. The doctors’ union wants pay rises to compensate for over a decade of real-terms pay cuts, with consultants experiencing a cut of up to 35%.

Planned strikes among junior doctors in Scotland were suspended following the negotiation of an improved pay offer from the Scottish government. The strikes were initially scheduled for 12-15 July after 71% of BMA junior doctors voted to reject an offer of a 14.5% pay rise over two years. At the time, this was seen as failing to compensate for the more than 28% real-terms pay cut junior doctors had experienced in Scotland since 2008. The government made a follow-up offer of a 12.4% increase for 2023/24, on top of last year’s 4.5% uplift – a cumulative total of 17.5% over two years – in addition to further increases in line with inflation for the next three years and a commitment to further annual pay negotiations. This offer was accepted by junior doctors before the strikes were due to begin.

A £21m artificial intelligence diagnostic fund was announced in June to support trusts to adopt AI-assisted diagnostic tools. Any diagnostic tool that demonstrated value for money was open to consideration and the Department for Health and Social Care said it hoped to roll out these tools to all stroke networks by the end of this year. In addition, the government committedS another £13m in August to fund 22 AI healthcare innovation projects at universities and trusts in England, including semi-autonomous surgical robots for removing tumours and systems to predict patients’ potential future health problems.

NR_shutterstock_sick kid_HALF PORTRAITThe NHS is expanding its hospital-at-home virtual ward service to include children across England. This follows successful treatment of 6,400 children in trials last year. The programme will provide hospital-level care for a wide range of conditions, including respiratory and heart conditions, from the comfort of the patients’ homes. The expansion forms part of a wider plan for the NHS to create 10,000 extra virtual ward beds by winter of this year to relieve pressure on hospital capacity.

NR_Peopl Promise_HALF PORTRAITIn response to changes introduced during the Covid-19 pandemic, a home and agile/hybrid working framework has been incorporated into the NHS terms and conditions of service handbook. The NHS Staff Council developed the framework to align with the NHS long-term workforce plan and the NHS people promise. It aims to accommodate the diverse needs of the workforce and provides definitions and guidance to help organisations create and update local policies. It also covers contractual considerations to help managers. The changes to the handbook go live in October.

NHS England has published its winter plan for 2023/24, building on its recovery plans for urgent and emergency care and primary care. The plan focuses on four areas: ensuring 10 high-impact interventions are in place; completing operational and surge planning; ensuring effective system working; and supporting the workforce. The body aims to launch an incentive scheme for providers with A&E departments to overachieve on their planned performance in return for a share of a £150m capital fund in 2024/25. Providers must achieve an average of 80% four-hour performance in A&E over the fourth quarter of this year. They must also complete at least 90% of ambulance handovers within 30 minutes during the second half of the year.

Health and social care secretary Steve Barclay has moved the inquiry into murders and attempted murders at the Countess of Chester Hospital onto a statutory footing. This means the inquiry, which will look at the circumstances surrounding the crimes committed by former nurse Lucy Letby, will be able to compel witnesses to give evidence under oath, with all evidence heard in public. Following the life sentencing of Ms Letby, there have been calls for NHS managers to be subject to regulation similar to the system governing doctors and nurses.

 

News in quotes
‘As we progress forward, we are committed to continuing to work closely with people in receipt of support and partners to design a system that ensures individuals and communities always experience high-quality care and support.’


COSLA spokesperson Paul Kelly on the ongoing development of Scotland’s national care service


‘It’s difficult to overstate the scale of the disruption as many services also avoid scheduling appointments for strike days, meaning that the true figure will be even higher.’

NHS national medical director Sir Stephen Powis on the impact of ongoing NHS industrial action

‘Having discussed this with the families, we will launch a full statutory inquiry giving it the legal powers to compel witnesses to give evidence. This statutory public inquiry will aim to give the families the answers they need and ensure lessons are learned.’

Health and social care secretary Steve Barclay uprates the inquiry around crimes committed by former nurse Lucy Letby

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‘The government should complete its work and create a sister plan for social care, with its own funding and own projections. This will be pivotal to achieving the ambitions in this NHS plan.’

King’s Fund chief executive Richard Murray (pictured) on the publication of the NHS long-term workforce plan

FROM THE HFMA
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Sanjay Agrawal
(pictured), consultant at University Hospitals of Leicester NHS Trust, has warned that cutting funding for prevention in the face of financial pressures would be short-sighted. In an HFMA blog, he says failing to implement pathways to reduce smoking and alcohol dependency would be negligent.

 

With mental health services under pressure, the sector needs an effective way to show its value, says Paul Sheldon in a recent HFMA blog. The chief finance officer of the Leicestershire Partnership and Northamptonshire Healthcare Group says the start point is defining what productivity looks like in mental health services and agreeing how to measure, record and compare it. He highlights ongoing work by the HFMA to make progress in this area.

• For more HFMA blogs visit: www.hfma.org.uk/news/blogs

The HFMA has launched HFMA Connect, a support community for NHS finance leaders. The network, run in collaboration with the HFMA Hub, aims to help finance leaders share knowledge and solutions. It will deliver monthly webinars, face-to-face forums and networking opportunities. In its first webinar on 22 September, King’s Fund chief executive Richard Murray will look at the NHS long-term workforce plan.

Spend analytics company AdviseInc  has signed up with the HFMA as a corporate partner. It said: ‘Over recent years our work has brought us closer to finance, using our analytics to deliver better purchase-to-pay insights and price/cost inflation analysis. We’re looking to build on our platform to develop more insights that support NHS finance teams get more from their data.’