News round-up (7 April 2023)

Waiting lists for NHS care continue to build up, with new statistics showing that some children are having to wait more than a year for treatment by community health services. There are also concerns, expressed in a report from government, that patients with serious health conditions are being referred inappropriately to social prescribing services. Breast cancer patients and charities will be pleased, however, that NICE has approved the drug olaparib for use amongst patients whose breast cancer is caused by a genetic defect.

Funding for social care held back by government

The government’s decision to hold back half of £500m it promised last year to tackle staff shortages in social care has been criticised by adult social care directors.

They said that the decision meant that vulnerable people would go without the care they need.

This week the government announced £2bn of grants for social care over the next two years, of which £600m is being held back. That £600m includes £250m of the money promised last year to fill staffing gaps.

Sarah McClinton, the president of the Association of Directors of Adult Social Services, said: “This plan leaves the government’s vision in tatters. It ducks the hard decision and kicks the can down the road until after the next election. Adult social care is in crisis. Now’s not the time to be holding funding back.”

Children experience ‘dangerous’ waits for NHS treatment

More than 12,000 children are enduring “dangerous” waits of more than a year for NHS support.

Children and young people under 18 are three times as likely as adults to face a wait of a year or more for help from community health services, NHS figures show.

The statistics, which track waiting times in community services, show that between October and January, the total number of adults on lists has fallen by almost 8% from 704,030 to 648,404. At the same time, the number of children facing such waits has risen by almost 4%, increasing from 206,504 to 214028 in four months.

While 1.8% of adults have been waiting more than 52 weeks, this goes up to 5.9% among children.

Dr Camilla Kingdon, president of the Royal College of Paediatrics and Child Health, said such delays were “dangerous,” warning that they could mean children missing the window for treatment, with lifelong consequences.

GP contract needs radical reform, Hewitt review warns

The Hewitt review into integrated care systems, published this week, argues that the GP contract is in urgent need of “radical reform” to enable greater flexibility and local autonomy.

With the current five-year deal in its final year, Patricia Hewitt’s review argues that now is the right time for change, as the government “will be shortly considering its intentions for the next iteration of the contract”.

Hewitt called on NHS England and the Department of Health and Social Care to convene a national “partnership” group to develop a new framework for GP contracts. She said the new approach should measure “outcomes rather than just activity” and warned that the Quality and Outcome Framework – which gives surgeries money for achieving a list of outcomes – is seen as “inflexible and bureaucratic” by both GPs and integrated care boards.

Cardiac nurses use smart glasses to help them carry out heart procedures

Nurses at the Essex Cardiothoracic Centre (CTC) at Basildon Hospital are wearing smart glasses to guide them through complex surgical procedures.

The glasses enable them to receive remote guidance via a live feed from the operating theatre through a high-resolution camera.

They are using the technology while carrying out a transcatheter aortic valve implantation (TAVI), which involves inserting a new valve via a blood vessel in the leg. Previously, staff carrying out the procedure would be advised by a clinical expert from the Boston Scientific medical device company, who would be present in the operating theatre. The new smart glasses mean this expert can now be situated anywhere in the world, helping to save time for patients and staff.

Dr Rohan Jagathesan, medical director at the Essex CTC, said: “This new innovative equipment allows us to be more independent and to carry out more procedures, and means we can treat patients more quickly as we don’t need a specialist to come to the hospital.”

NHS in England to offer new cancer drug to breast cancer patients

The NHS England is to offer thousands of breast cancer patients the world’s first cancer drug to target an inherited genetic fault.

The drug, olaparib, treats breast cancer in women with HER2-negative, high-risk early breast cancer who have inherited faults in their BRCA1 or BRCA2 genes. Olaparib reduces the risk of breast cancer returning within four years by nearly a third.

Last year, the National Institute for Health and Care Excellence (NICE) chose not to recommend Olaparib because of its high cost. Its list price is £2,317.50 for one pack of 150mg tablets, excluding VAT.

NHS England has now struck a deal with AstraZeneca to provide the drug at an undisclosed discount, however, leading NICE to reverse its decision.

Patients referred for social prescribing may have severe health problems

Patients with severe health problems are being referred inappropriately for social prescribing schemes, according to a new government report.

The report, National green social prescribing delivery capacity assessment, which looked into the provision of “green” social prescribing provision in England with the aim of guiding a national roll-out, found a “worrying pattern of link workers and green activity providers receiving patients with complex health conditions that they are not equipped to work with”.

It also found considerable variation in the types of activities offered, availability of accessible green space and the number of providers even between neighbouring primary care networks.

For people with moderate to severe mental health conditions, there is a lack of specialist support available to access green social prescribing schemes which can “place unfair demands” on providers and is also “unfair and risky” for the individuals referred to them.