Healthmatters is an online magazine provides a platform for challenging debate and comment on topical issues of policy and practice in the fields of healthcare, social care, public health and wellbeing.
Responding to Secretary of State for Health and Social Care Matt Hancock’s speech outlining his early priorities, Niall Dickson, chief executive of the NHS Confederation, which represents organisations across the health and care sector, said:
“The priorities outlined by the new Secretary of State are very encouraging and will strike a positive chord with our members who have long argued that workforce, technology and transformation to develop services in the community are central.
“Next we need to see the detail. It is imperative clinical staff and the public are involved in shaping any long-term plan – but crucially this must be a health and care plan, not an NHS plan.
“In March the Prime Minister promised to correct the mistakes of previous Governments by putting an end to ‘siloed’ working and integrating health and social care so that demands on the NHS are better managed. This work must begin now, not later, otherwise we risk slipping back into the age-old habit of fighting NHS fires rather than planning for the long-term.”
Alzheimer’s Research UK is calling for urgent investment in dementia research, following new statistics that show the condition accounted for 13% of all UK deaths last year. The figures were released by the Office for National Statistics today (Wednesday 18 July).
Data for 2017 shows that in total, there were 67,641 deaths attributed to Alzheimer’s disease or other forms of dementia – 13% of the total deaths recorded that year. This is a rise from 2016, when there were 62,948 deaths from dementia (12% of all those recorded).
Dr Matthew Norton, Director of Policy and Strategy at Alzheimer’s Research UK, said:
“These figures yet again underline the overwhelming impact of dementia for the UK, and for hundreds of thousands of families who are hit by the condition. With one in four hospital beds occupied by someone with dementia and deaths from the condition rising, we must take urgent action. As well as support for dementia research, the condition must become a priority for the NHS 10-year plan.
“Scientific advances have meant deaths from many serious diseases are now falling and by investing in dementia research, we can offer the same hope for people affected by the diseases that cause dementia, most commonly Alzheimer’s. We must make dementia research a priority if we are to bring about much-needed life-changing treatments.”
Responding to the JCVI’s (Joint Committee on Vaccinations and Immunisations) recommendations that boys should also be vaccinated for HPV, BMA board of science chair Professor Dame Parveen Kumar said:
“This is an important moment for public health for which the BMA has long campaigned and we’re glad to see the JCVI (The Joint Committee on Vaccinations and Immunisations) recognise all children should be immunised against HPV1 reducing the risk for hundreds of thousands of people of contracting cancer.
“It makes that sense we are following the lead set by countries like Australia, Canada and the USA and introducing universal HPV vaccination. School aged girls have routinely been vaccinated against HPV which is known to cause cervical cancer and this has had a great impact in reducing its prevalence, but boys also need protection as more evidence emerges of the relationship between HPV and cancers that affect men.
“Current measures such as offering vaccinations at sexual health clinics to men who have sex with men aged 16 to 45 are not effective in combatting the risks this disease poses as they’re often already sexually active and it’s too late to prevent. This won’t save money for the NHS.
“In order to properly protect people against HPV infection, this will be added to the school immunisation schedule as soon as possible.”
Readers of News from Nowhere know that working in the NHS is no quiet mission. Just the opposite, the flak rises to greet all new entrants, but is especially intense for politicians. Even before he had settled into Jeremy Hunt’s shoes, the National Health Executive website alleged that new health secretary Matt Hancock had accepted donations from the chairman of a think-tank that supports the privatisation of the NHS, the Institute of Economic Affairs (IEA). The donations include £4,000 given to Hancock on 29 November 2013 to support parliamentary work and travel costs, following a similar amount in 2012.NHE reported on July 13th that the Charity Commission will investigate whether or not the IEA breached charity regulation over political independence.
And another thing
Responding NHS England’s latest performance figures, Niall Dickson, chief executive of the NHS Confederation, which represents organisations across the healthcare sector, said:
This is a baptism of fire for the new health secretary. These performance figures show a system under intolerable strain with growing accident and emergency attendances and emergency admissions. This is now the day-to-day reality of life at the clinical coal face, but it cannot go on. The government’s funding settlement for the NHS should be welcomed – it is a lot more than has been offered in recent years and importantly it is a five-year deal which should help to provide at least a degree of stability. Of course, it is not enough, but if it is used wisely and the government also invests in social care, we should do everything we can to see that it makes a difference. It will be critical though to invest in ways of providing care in the community to reduce the pressures on hospitals and other services. If instead we use the extra money to prop up the existing system, we will surely fail and patients will suffer.”
The Resolution Foundation reminds us that on of Teresa May’s first promises was to put injustices right. She has had other things on her mind since then, so the Foundation decided to refresh her memory about health inequalities, race discrimination, social mobility and the gender pay gap, as well as home ownership, insecure work and the cost of living. You can see the Foundation’s analysis at www.resolutionfoundation.org/media/blog/top-of-the-charts-burning-injustices-special-edition/ but here’s the comment on Health inequalities:
“We live in a country where if you’re born poor, you will die on average 9 years earlier than others. This is about as burning as an injustice gets: if you live in a poor area you can expect to die a lot earlier. In England the gap between the richest and poorest areas is over 7 years for women and 9 for men. This gap may have narrowed in the 2000s, but more recently the gap has been growing again. But the really bad news that has emerged on Theresa May’s watch is less about health inequality and more just about health: mortality rates have stopped falling to a significant extent since 2011, meaning life expectancies are not rising as quickly as we used to think. They are of course still improving, just more slowly, and the government has announced £20 billion extra NHS spending, so it’s not all doom and gloom…”
Mergers and acquisitions in the commercial sector
It is not just the NHS that has to reorganize itself. The first half of 2018 has seen mergers and acquisition (M&A) and investment activity in the UK Healthcare sector remain high, according to data from Alantra, the global investment banking and asset management firm. The first six months of the year saw 65 deals, compared to 83 during the same period last year and M&A momentum is expected to continue for the second half of 2018, as a result of favourable market drivers.
Justin Crowther, a Partner in the UK advisory business of Alantra, has identified the following significant healthcare deals and market drivers that have positively impacted on M&A activity in the industry during the first half of 2018.
Strong private equity appetite for market-leading platformsCore. Equity, the Belgium-based private equity firm, acquired Portman Dental Care following a competitive dual track process involving serial acquirers such as Jacobs Holdings. Core Equity recorded the highest first-time fundraise in 2017. It has about €1bn of capital to deploy in market-leading platform companies with substantial opportunities to generate value over long periods of time. Portman’s strong reputation, geographic positioning and ability to access an extensive clinical network embedded in the UK private health system aligns neatly with this investment philosophy. Portman offers an attractive opportunity for further consolidation within the UK, whilst potentially providing a launch pad to create a pan-European market leader.
UK market access remains a high priority for international acquirers. Virtus Health Group (Virtus), the listed Australia-based provider of in-vitro fertilisation services, continued its international growth strategy with the acquisition of Complete Fertility (90% stake). The UK fertility market is of key strategic importance due to its strong international healthcare reputation, well-regulated market and the ability to implement the most advanced treatments by combining recent advancements in technology with unparalleled scientific capability. The fertility services market, underpinned by favourable market drivers, remains a hot-bed of activity and this trend will continue.
Specialist care market attracting a new breed of institutional investors. Antin, the specialist infrastructure fund, followed up its recent investment in Kisimul Schools with the acquisition of Hesley Group, the specialist residential care service provider for adults and young people with autism and other complex needs. Infrastructure funds are increasingly looking towards the fragmented specialist care market as a source of non-cyclical growth that will generate stable cash returns for investors. Other notable investments by infrastructure funds include AMP Capital’s acquisition of The Regard Partnership and Montreux Capital’s investment in Active Assistance.
Increasing number of social care M&A transactions. Domiciliary and elderly care providers, especially those funded through local authorities, remain exposed to a difficult operating environment. Government austerity measures combined with the introduction of the National Living Wage are placing significant pressure on margins resulting in a slowdown in M&A activity in this space. However, the acquisition of the domiciliary care business Ark Home Healthcare by City & County is a signal of intent by a key strategic buyer in the field – is this an early indication that social care M&A activity is on the up?
AI and health services
A report from PricewaterhouseCooper (PwC) on the impact of AI and robotisation on work suggests that the most positive effect will be seen in the health and social work sector, where PwC estimates that employment could increase by nearly 1 million, equivalent to around 20% of existing jobs in the sector. By contrast PwC estimates the number of jobs in the manufacturing sector could be reduced by around 25%, representing a net loss of nearly 700,000 jobs. Healthcare is likely to see rising employment as it will be increasingly in demand as society becomes richer and the UK population ages. While some jobs may be displaced, many more are likely to be created as real incomes rise and patients still want the ‘human touch’ from doctors, nurses and other staff. Go to www.pwc.com. for the UK Economic Outlook report of July 17th 2018.
Responding to the publication today of NHS Resolution’s annual report and accounts 2017/18, which show the cost of clinical negligence claims increasing by 50 per cent, Niall Dickson, chief executive of the NHS Confederation, which represents health service organisations across the healthcare sector, said:
“We cannot go on like this with the NHS spending more and more on litigation. The number of new negligence claims has not risen in England but the amount paid in damages has rocketed by 50 per cent in one year to £1.68 billion in 2017/18. That is a staggering total.
“Part of this is down to a foolish change in the way compensation is calculated, which will hopefully be addressed by Parliament, but this still paints a hugely troubling picture.
“It is right and fair that there must be reasonable compensation for patients harmed through clinical negligence and we need to do everything we can to eliminate these mistakes.
“But the justifiable case for compensation has to to be balanced against society’s ability to pay and the fact that we have a free at the point of use health care system.
“Money that is used for this purpose cannot be used for frontline care. At a time when NHS finances are already under enormous strain, this just makes things worse. Unless we deal with this, a sizeable chunk of the new money being promised will be swallowed up by these claims rather than used for much-needed investment to help the mass of patients.”
Jeremy Hunt has gone to the Foreign Office -Matt Hancock is the new Health Secretary. Of course, bothwere in a Tory Government which has presided over austerity since 2010 . NHS funding has flatlined, social care budgets cut because of local authority funding cuts -and there is an increase in poverty levels and reduction in life expectancy due to wider societal deprivation. So, whatever happens in the NHS and Department of Health, we have a background of wider society issues -and of course, Brexit. So on one level, the details of who is health secretary is irrelevant.
Theoretically, since the 2012 Lansley reforms , the Secretary of State for Health no longer has responsibility for running the NHS – NHS England is” independent” -and commissions services .Regulators both of quality (CQC )and finance(Monitor, now NHS Improvement) were meant to ensure delivery of safe efficient high quality services. However, Jeremy Hunt was very interested in the running of the NHS, monitoring waiting times, A and E performance etc. and was known to ring up hospital Chief Executives if their hospital performance was not up to scratch. There has been a huge “workaround” of the legislation, which was meant to promote more competition -now providers are being asked to collaborate over larger geographical areas in the STPs to move to more integrated care.
It will be interesting to see if the new Secretary of State takes a “hands off “approach to the NHS or will be as involved in the day to day running. His relationship with Simon Stevens, NHS Chief Executive will be key.Prior to joining Parliament; he worked for the Bank of England and as economic advisor to George Osborne. He also has links to the Institute of Economic Affairs, a free market think tank, which regularly calls for the NHS to be replaced by an insurance based system.
Will he try to push that agenda? Will he be more hawkish about NHS finances? Will he continue the “workarounds” of the Lansley reforms?
To increase the value of their work for decision-makers, and in keeping with the aspiration to “leave no one behind”, the Office for National Statistics has collaborated with the City, University of London and the London School of Economic and Political Science to identify the characteristics and circumstances associated with the poorest personal wellbeing in the UK. David Tabor, part of the Quality of Life team at ONS, explains how this work enables more strategic action for policy makers and service providers to improve the lives of those in most need. Our data shows that, between January 2014 to December 2016, an estimated 1% of people in the UK (over half a million people) reported “poor” ratings across all four personal well-being questions. Our analysis published today looked, for the first time, at some of the key factors common to those people with the poorest personal wellbeing.
Unemployed or inactive renters with self-reported health problems or disability
Employed renters with self-reported health problems or disability
Retired home-owners with self-reported health problems or disability
IMPORTANCE OF HEALTH
Using regression analysis, we found self-reported health to be the most important factor associated with the poorest personal wellbeing. Individuals reporting very bad or bad health were 13.6 times more likely to report poorest personal well-being compared to those reporting good or very good health. Self-reported disability was another significant predictor of poor personal wellbeing, but to a lesser extent than self-reported health.
SOURCE: ANNUAL POPULATION SURVEY, 2014 TO 2016 NOTE: THE CATEGORIES WITH AN * ARE STATISTICALLY SIGNIFICANT WHEN COMPARED WITH THEIR REFERENCE CATEGORY
The economic activity of an individual also seems to play a part here – students were found to be the least likely to experience very low wellbeing. Unpaid family workers – people who work in a family business and do not receive a formal wage or salary but benefit from the profits of that business – were the group most likely to report the poorest wellbeing. Cross-over with loneliness The findings of this work are consistent with previous research, which looked at the factors contributing most to personal wellbeing. We have also used similar methods to examine what factors are associated with feeling lonely. There seems to be cross-over here, where we have found that poor health and unemployment are important characteristics that have an impact on loneliness. These types of analyses provide some in-depth information that could be used to target support more effectively towards those groups of people who may be struggling the most in society.
UK and European healthcare providers see new printing technologies as essential in meeting growing patient demands and personalising treatments
From easing budgetary pressures to personalising care for chronic conditions, a new study commissioned by Ricoh reveals the disruptive impact new printing technologies are having on UK and European healthcare systems. According to the research, 68% of healthcare professionals believe that new printing technologies have the potential to fundamentally transform the health sector.
Including advances in customised prosthetics and on-demand drug manufacturing, 74% of healthcare experts now use new printing technologies to improve accurate diagnostic rates and lower mortality rates. In addition, 51% say applying new printing technologies to rapidly manufacture customised implants, such as bone and dental grafts, significantly reduces the time patients need to spend in hospital and are crucial for improving recovery times.
David Mills, CEO, Ricoh Europe says: “Tasked to do more with less, making use of innovative printing technologies will prove essential in enabling Europe’s healthcare systems to continue to provide high-quality care. New techniques, such as printing aquagel organs, means it’s now possible for surgeons to practise suturing and the removal of tumours before real-life operations. Printing medicines layer-by-layer to target specific diseases could soon be commonplace.”
With life expectancies increasing and the prevalence of chronic diseases rising across Europe, treatments are becoming more complex in nature as ailments affect patients later into their lives. In response, 65% of healthcare providers are using new printing technologies to tailor printed materials to differing needs, including those of older and remote patients.
46% of healthcare professionals go so far as to say that without investment in 3D-printing, they will struggle to meet the needs of patients in the next five years.
Mills adds: “It’s not just through cutting-edge developments that healthcare facilities are benefiting from advances in printing technologies. Healthcare is an intensely admin heavy sector. By digitising their systems, providers can reduce paperwork to save time, cut costs and improve security.”
An employee calling in sick to work is considered completely acceptable if it’s for a migraine, stomach bug or physical injury. But what about the days a member of staff is at work and although they’re not physically ill, mentally they are absent?
It’s estimated that mental health-related presenteeism costs employers up to 3x the cost of mental health related absence1. This equates to an annual cost of £16.8bn to £26.4bn for UK business. So does it make sense to treat a mental health absence with the same approach as a physical sickness day?
Last year, Britons took 137million sick days, of these, 15.8million were for mental health issues (stress, depression, anxiety, bipolar or anything else). ‘Mental health days’ are a way of ensuring employees are 100% mentally present at work meaning they will inevitably be more productive.
Director of Wellbeing at Westfield Health, Richard Holmes, explains how employers can prevent mental health absences and why it’s important for employers to allow for ‘mental health days’ off work.
On-site stress busters
“Work is the most common cause of stress in British adults, with 59% of employees suffering from stress in the workplace2. By reducing stress at work, it will prevent employees taking mental health-related absences in the first place. Businesses can introduce schemes and techniques such as relaxation sessions, chill-out zones and exercise classes to help employees unwind and switch off from their workload.”
“It’s important to encourage employees to talk openly and freely about how they feel mentally. This can be encouraged by line managers by ensuring they are approachable and have an open door policy. Organising social activities is a good way to help colleagues get along outside work whilst making them feel more at ease when it comes to talking about their mental health.”
Encourage staff to get out the office
“Not only is eating at your desk bad for your body, it’s bad for your work and your mental health. Getting fresh air and a change of scenery will mean employees return to their desks feeling recharged and less stressed. It is also a good way to encourage employees to get out the office and exercise. When exercising, endorphins are released which have been proven to reduce stress, boost self-esteem and ward off feelings of anxiety and depression.”
Create a flexible work environment
“Employee benefits aren’t just about a high salary or extra holiday days. Businesses that have a flexible work schedule are more likely to retain staff as it gives them the ability to manage a work-life balance3. By businesses adhering to employees individual needs (e.g. school runs and participating in hobbies), it will reduce the stress and pressure of everyday life. Likewise, if businesses allow staff to work from home when feeling mentally unwell, it will reduce the stigma behind mental health absenteeism.”
Introduce a workplace wellbeing programme
“A surge in over stressed and over worked employees has led to a rise in mental health absenteeism. One way that businesses can improve this is by introducing a workplace wellbeing programme which encourages staff to manage and speak openly about their physical and mental health. By introducing initiatives like this, businesses are more likely to have a happier and healthier workforce, reducing avoidable absenteeism.”
More than four in five of us would be willing to pay more tax to secure significant improvements in the NHS, according to a new poll commissioned by the NHS Confederation.
84% of participants polled would be willing to pay more tax if the NHS’s level of service ‘improved a great deal’, compared with 75% who would be willing to pay more tax for slightly improved services. 61% would be willing to pay more if it ensured that services remained at current levels. The Ipsos MORI poll surveyed 1,004 adults aged 18+ across England, Scotland and Wales.
The government’s five-year funding deal for the NHS is equivalent to an average of 3.4% a year increase. This is below the 4% a year the report from the Institute for Fiscal Studies and the Health Foundation said would be necessary for the health service to cope with rising demand and to ‘modestly’ improve.
The NHS Confederation has argued that any additional funding should not merely be spent on the same services but instead on transforming service so that patients can be treated closer to home.
In her speech announcing the NHS funding, the Prime Minister said people should not end up “stuck in hospital when they could be better cared for in the community or at home”.
More than double the proportion of participants agreed (42%) than disagreed (18%) that any extra funding for the NHS should focus more on providing care closer to home and less on hospital care.
Niall Dickson, chief executive of the NHS Confederation, which represents organisations across the healthcare sector, said:
“The poll shows that the British people are willing to pay more for better care and that there is an understanding we have to change the way we deliver care – we cannot go on as we have been.
“But we must not raise expectations about what can be achieved – there will be tough decisions ahead. The settlement is welcome, but falls short of the 4% independent experts say we need to deliver even modest improvements.
“It is now undeniably clear there is an appetite among the taxpayers to put their hands in their pockets for the cash we need to make the NHS a service we can be proud of in its 70th year and for the years to come.
“Just pumping money into a struggling system will not work. Healthcare must be patient-centred, with more focus on primary care, community health services and social care, all of which can help ensure people receive quality care in or near their own homes.”