The Loneliness Strategy is Government’s first step in tackling the long-term challenge of loneliness. Loneliness is a complex issue that affects many different groups of people, and the evidence base on it is still developing.
BGS members’ experience of working on issues around loneliness includes:
People in poor health
BGS members’ position on institutional initiatives to tackle loneliness amongst older people
We welcome the cross-departmental approach that Government is taking to developing its strategy for tackling loneliness and social isolation. We hope very much that the strategy will be widely promoted and adopted across Government departments.
In summary: the Government recognises that we need more nurses. That is why additional clinical placement funding was announced by the Department of Health in August and October 2017 and why as part of changes announced on 15th June, the Government will be exempting nurses and doctors from the annual Tier 2 (General) cap on a temporary basis, pending a review by the Migration Advisory Committee on the composition of the Shortage Occupation List. Collectively, these changes will enable around 5,000 more nursing students to enter training each year from September 2018; an historic increase. Furthermore, we are working to broaden routes into nursing through the nursing associate role and the nurse degree apprenticeship. This will open up routes into the registered nursing profession for thousands of people from all backgrounds and allow employers to grow their own workforce.
The Government also accepts the need to give clear messaging to EU nursing staff working across health and social care and the need to develop ethical overseas recruitment programmes at scale. That is why, on 8 December 2017, the UK and the EU Commission reached an agreement to safeguard the rights of people who have built their lives in the UK and EU, following the UK’s exit from the EU.
The Department agrees on the need for robust, timely and publicly available data at a national, regional, and trust level on the scale of nursing vacancies. We would emphasise again that the latest figures estimate around 36,000 nursing roles were not filled by a substantive member of staff, of which around 33,000 were being filled by agency or bank staff. We also recognise the importance of transparent, robust supply and demand projections which include demographic and other demand factors alongside considerations of affordability, as well as the requirement to account for nurses working in the NHS, adult social care, primary care and other settings. Such robust and comprehensive data will provide the foundation for the flexible workforce of the future.
Professor David Stott will be retiring as Editor (in Chief) of Age and Ageing, journal of the British Geriatrics Society, at the end of 2018 and expressions of interest are invited from qualified candidates to succeed him in January 2019 after a period of handover. The Editor shall serve for five years, which period may be extended for one further year by mutual agreement.
Requirements The Editor has responsibility for the overall editorial process. He/she needs to become fully conversant with the editorial software, ScholarOne Manuscripts (Manuscript Central), used to manage the submission and peer review process. Applicants should hold current membership of the British Geriatrics Society. The Editor should expect to commit one day per week, on a flexible basis, to the editing of the journal.
The RCP's Guidance on safe medical staffing working party report aims to help those planning and organising core hospital medical services to answer the question: ‘How many doctors or their alternatives, with what capabilities, do we need to provide safe, timely and effective care for patients with medical problems?'.
Within the medical profession there is widespread concern that levels of medical staffing have fallen dangerously low. From 2013 to 2018, more than one in five census respondents reported that gaps in trainees’ rotas occurred so frequently as to cause significant problems in patient safety. Half of all advertised consultant appointments in acute internal medicine and geriatric medicine went unfilled due to a shortage of suitable applicants.
The results of the RCP Medical Registrar Survey (Appendix 2) and feedback from RCP members and fellows suggest that the out-of-hours workload of the medical registrar on-call is inappropriately onerous, with implications for patient safety.
The practice of a single medical registrar both leading the medical intake and providing on-call medical cover for the hospital is unlikely to be successful and contributes to the heavy out-of-hours workload of the medical registrar on-call.
It is essential that as much patient care as possible is delivered during the normal working day, rather than out of hours. We think that this is a key issue for patient safety, and the daytime staffing of wards should be such as to minimise ‘legacy’ work.
Service must always support training and we have concerns that the significant increase in consultant-delivered care may limit the opportunities for trainees to acquire experience in decision making. We urge trusts to recognise trainees’ educational needs when implementing consultant-delivered services.
There must always be sufficient time available to speak with patients and their families and carers to ensure that all the relevant issues are known to the medical team who are caring for that patient. This is particularly important when a patient is unable to represent themselves adequately.
This report represents the start of an ongoing process to help hospitals ensure that they have sufficient medical staff to meet the needs of their patients and deliver safe patient care. The RCP will work with the NHS to refine the method in different hospitals.
Prof Sir Chris Ham and Richard Murray writing for The King's Fund 12 July 2018: The government has announced increases in NHS funding over five years, beginning in 2019/20, and has asked the NHS to come up with a 10-year plan for how this funding will be used. After eight years of austerity, growing financial and service pressures within the NHS and the damaging and distracting changes brought about by the Health and Social Care Act 2012, there is now an opportunity to tackle the issues that matter most to patients and communities and to improve health and care.
In our view, the centrepiece of the new plan should be a commitment to bring about measurable improvements in population health and to reduce health inequalities. Health outcomes in the UK are not as good as those in many comparable countries despite recent progress in some areas such as cancer survival rates (Dayan et al 2018). Action is required across government as well as in the NHS in order to give greater priority to prevention and to tackle the wider determinants of health and wellbeing. Goals for improving health should be set following widespread consultation with the public and stakeholders.
Improving health and reducing health inequalities depends on making further progress in integrating health and social care, building on the development of new care models, sustainability and transformation partnerships (STPs) and integrated care systems (ICSs). An immediate priority is to communicate more effectively about why integrated care matters and about the benefits it will bring to people and communities. Some of the additional funding that has been announced should be earmarked to support the further development of integrated care with a focus on the needs of older people with frailty, people with complex needs and children.
Reported in the Guardian (3 July 2018): No health system has all the answers, and there are certainly lessons the NHS can impart. But if the NHS is to thrive it needs to draw on the knowledge and experiences of other countries.
New Zealand: integrated health and social care In the early 2000s, the health system in Canterbury on New Zealand’s South Island was under pressure as a result of increasing demand, leading to questions about its sustainability. But since it introduced an integrated health and social care system in 2007, Canterbury has turned around its fortunes.
Sweden: paediatricians on the frontline When it comes to the increasing pressures on the NHS, the spotlight often falls on Britain’s ageing population. But demand for services is also increasing among other age groups. In the UK the first port of call for parents is usually the GP, who will often have limited training in paediatrics. By contrast, in Sweden GPs and paediatricians are co-located in health centres where there is parental support, health education and promotions, all important for preventing ill health.