News review – April 2020

In this environment it’s difficult to get beyond the daily prime ministerial briefings, the number of cases and, sadly, deaths. However, before governments and central bodies started to intervene in mid-March to better prepare the NHS, news not related to Covid-19 continued to flow.

Health Education England has responded to a 6% increase in applications for nursing degree courses by pledging to invest up to £10m in additional clinical placements in 2020/21. HEE’s chief nurse Mark Radford said the funding would increase nursing capacity and build on the investment that enabled an extra 1,400 student nurses to start their training in September 2019. He told the chief nursing officer’s summit in Birmingham that there would be further investment in learning disability nurse training, return to nursing programmes and supporting nursing associates and apprentices to train as registered nurses.

Local authorities’ public health grant will total £3.279bn in 2020/21, the government has announced. In 2019/20, the grant was £3.134bn. A Department of Health and Social Care circular said the ring-fenced grant includes an adjustment to cover Agenda for Change pay costs . This is for eligible staff working in organisations commissioned by local authorities to deliver public health services. The circular also includes an outline of the allocations to be given to eligible local authorities. The NHS Confederation welcomed the news, but, with the announcement made just two weeks before the new financial year, it warned that there was little time to adjust plans.

Also in public health news, the Department of Health and Social Care is to give local authorities £16m in 2020/21 to provide the preventative HIV treatment PrEP. The drug will be available from local sexual health clinics and the funding will support the cost of delivering the service. The Department will cover the cost of the drug. The availability of PrEP is part of the government commitment to reach zero HIV transmissions by 2030.

Stephen Boyle (pictured) has been nominated by the Scottish Parliament to become the new auditor general for Scotland. Subject to the Queen’s formal appointment, Mr Boyle will succeed current auditor general Caroline Gardner when her term finishes at the end of June. He is currently an audit director at Audit Scotland, where he leads on central government audit. Mr Boyle is also the appointed auditor of the Scottish Police Authority, the Scottish Public Pension Agency and Registers of Scotland.

Fife Integration Joint Board – the body responsible for planning local health and social care services – is facing ‘significant and ongoing financial problems, with recurring overspends’, according to the Accounts Commission. It said the board had overspends in the past three financial years. The overspends had been covered by NHS Fife and Fife Council, the board’s partners. In a report, the commission said ongoing financial pressures are likely to undermine the joint board’s efforts to improve services. Although the board had made recent progress, the commission said significant short- and medium-term financial issues are likely to remain until transformation of services can be achieved.

Only a quarter of GPs are satisfied with the amount of time they have to spend with patients, according to the Health Foundation. Its study examined GP satisfaction across 11 high-income countries, and found that only GPs in France were less satisfied with practising medicine and only those in Sweden reported higher levels of stress. Six in 10 UK family doctors said their job was extremely or very stressful, while 49% plan to reduce their working hours in the next three years. The average length of a GP appointment in the UK is 11 minutes, compared with a 19-minute average across the 11 countries.

Putting the ‘national’ back into the national health service means taking a single platform approach in the way some services, such as the back office, are delivered, and having a consistent set of standards, according to health secretary Matt Hancock. He said the NHS was not a monolithic body, and there is no single NHS back office, for example. Trusts had their own systems for a range of non-clinical services, leading to duplication, and no national data architecture has been put in place. He added that better healthcare lies in the delivery of ‘millions of incremental improvements’. However, such changes need strong accountability, the right data, funding and trust.

NHS productivity grew by 1.26% between 2016/17 and 2017/18, according to the University of York Centre for Health Economics. A report updating its examination of NHS productivity with 2017/18 data, said that since 2009/10, productivity had grown much faster than in the wider economy. It said that NHS outputs increased by 1.72% in 2017/18, adding about 0.35 percentage points to the cost-weighted growth rate.

Finally, there has been some speculation that the coronavirus pandemic response could lead to NHS services being transformed more quickly. The Welsh government said it had approved a faster implementation of video health consultations as part of its response to Covid-19. The government said that the new web-based platform would allow those in isolation to have face-to-face care and advice from their GP, while also helping relieve some of the pressure on the NHS. The service, which has been piloted at Aneurin Bevan University Health Board since 2018, is part of the government’s £50m Digital Priorities Investment Fund.