Health and care sector latest developments
CQC found to have "significant internal failings"
A highly critical interim independent review of the Care Quality Commission has found ‘significant internal failings which [are] hampering its ability to identify poor performance at hospitals, care homes and GP practices’.
The Department of Health and Social Care has published a statement on the interim report, led by North West London Integrated Care Board chair Penny Dash, and set out four immediate steps in response, including bringing in Professor Sir Mike Richards to review CQC assessment frameworks.
Health and social care secretary Wes Streeting said the CQC was “not fit for purpose” and added that he was “stunned by the extent of the failings of the institution that is supposed to identify and act on failings”.
Mr Streeting said: “We cannot wait to act on these findings, so I have ordered the publication of this interim report so action can begin immediately to improve regulation and ensure transparency for patients.”
The CQC said it accepted the findings in full, acknowledging there are “clear areas where improvement is urgently needed”.
Responding to the government's announcement on the immediate steps to be taken following the publication of an interim report into the failings of the Care Quality Commission, chief executive of the NHS Confederation Matthew Taylor said:
“Health leaders recognise that there have been a number of failings, already acknowledged by interim Care Quality Commission chief executive, in rolling out the new regulatory assessment regime and they and the teams they manage often report feeling overloaded and dissatisfied with the state of the present model of regulation.
“NHS leaders frequently say they feel the current system is out of step with the parameters in which they are operating and doesn’t recognise the full extent of the pressures they are working under.
“So our members will be pleased to see the government is taking swift action on the failings identified as set out in the interim report of the regulator by Dr Penny Dash, chair of the North West London Integrated Care Board, with whom the NHS Confederation and its members have engaged in this ongoing review.
“Identifying these failings is the first of many steps it will need to take towards improvement, and we look forward to working with the CQC to develop solutions to restore the confidence of our members and the public in the future regulation of the NHS and adult social care.”
ICB leaders ‘by-passed’ in the planning of acute services, says report
Variation in the way NHS England and its regional teams work with ICB leaders on acute management ‘underestimates’ their role in reducing demand, says a report published today.
The Hewitt Review: Where Are We One Year On?, an NHS Confederation report, looks at progress since former Labour health secretary and chair of Norfolk and Waveney ICB, Patricia Hewitt, conducted an independent review into ICSs in April 2023.
It highlights that ICB leaders have shared examples of being ‘by-passed by NHS England regional and national teams in the management of acute services’ which it says ‘underestimates the role of the rest of the system in reducing demand on services and improving discharge of patients’.
‘NHS England performance meetings focus almost solely on short-term issues at the exclusion of longer-term reform – both are crucial to NHS recovery and sustainability. This is also reflected in the draft oversight framework delivery metrics, which lean more heavily towards acute services than, for example, community and mental health services,’ the authors, Annie Bliss and Edward Jones, state.
They highlight that recent pressures and the ‘short-termist political climate’ have impeded ICSs, resulting in slow progress in implementing recommendations from the Hewitt review, such as streamlining data collation and reducing top-down micro-management to enable a focus on improvement in health outcomes.
Hewitt’s top recommendation was to move resources towards prevention but the report says while this has received attention from the Department of Health and Social Care (DHSC) analysis by the Nuffield Trust shows the proportion of NHS spending going into acute care has actually increased between 2016 and 2023.
The report is critical of the ‘several years’ it will take DHSC and NHS England to define and measure spending on prevention.
Cost of England’s four biggest killer diseases could hit £86 billion by 2050
The cost of cancer, heart disease, dementia, and stroke in England could rise to £86 billion a year by 2050 due to an ageing population, according to research published in the Lancet Healthy Longevity journal. These diseases, which currently cost £51.9 billion annually, account for 59 per cent of all deaths and 5.1 million years of life lost.
Experts have urged the government to take strong action against alcohol, junk food, and smoking to improve public health and prevent overwhelming future costs. Streeting has made turning the NHS into a more prevention-led service one of his key priorities as Health Secretary.
Cancer treatment ‘biased against ethnic minorities’
A type of cancer treatment used in the NHS appears to be biased against non-white European patients, research has found.
A review by the NHS Race and Health Observatory (RHO) in partnership with Liverpool University – findings from which have been shared with HSJ – looked into crucial genetic tests carried out before a type of drugs to treat cancer (fluoropyrimidines) is administered.
If a patient has certain gene variants, using the medicines can harm them, leading to severe side-effects that affect the bone marrow, bowel and skin, and in some cases can cause death. If the variants are present, other treatments have to be used.
However, the research by the RHO found that the NHS is testing for four variants, which are typically found in white Europeans. But the researchers found 53 additional relevant variants, which are not tested for, were present in patients from 12 countries and five ethnic groups – African American, East Asian, Latin American, Middle Eastern and South Asian.
Although their two-year research project is still ongoing, the RHO and Liverpool University team have decided to issue a call for an extension of this type of genetic testing (which seeks to identify a deficiency of the dihydropyrimidine dehydrogenase enzyme).
Eleven ICSs warned of ‘significant concern’ about overspending
Around three quarters of England’s 42 integrated care systems have been unable to set balanced budgets for 2024/25, NHS England (NHSE) has revealed.
Chief financial officer Julian Kelly’s paper to NHSE’s July board meeting, held yesterday, said 31 ICSs were planning deficits for this financial year.
Mr Kelly said there was “no room to cover any further pressures” after NHSE had provided funding to cover the gap in local budgets, which adds up to £2.2 billion. It comes with ministers deciding imminently on pay uplifts for 2024-25 and how they will be funded.
The CFO told the meeting systems had already fallen behind their financial plans in the first two months of the year and stressed the funding settlement, close to flat in real terms, was “really tight”.
And in a related development, HSJ has learned that NHSE wrote to another 11 ICSs this week, warning it has “significant concern” about their finances, further underlining the system’s financial fragility.
The move follows nine ICSs with the highest risk of overspending being ordered to bring in consultants for a rapid review of efficiency plan earlier this month.
Assisted dying bill introduced in parliament
A bill which would allow terminally ill adults with six months or fewer to live to get medical help to end their own lives has been introduced in the House of Lords, by former Labour Justice Secretary Lord Falconer.
He told the BBC his bill would apply only to people "mentally able to make the decision". Their choice would also need to be approved by two doctors and the high court.
Private members' bills introduced in the Lords rarely become law. However, Lord Falconer says he hopes a backbench MP will introduce a similar bill in the Commons, where it will have a greater chance of success.
Families of infected blood victims eligible for compensation from October
Minister for the Cabinet Office, Nick Thomas-Symonds, has announced that the families of those who passed away as a result of the infected blood scandal will be eligible to apply for a compensation payment of £100,000 in October if they have not yet received any financial support.
Speaking to the House of Commons, Mr Thomas-Symonds reiterated the apology issued by former Prime Minister Rishi Sunak.
John Glen, who now serves as shadow cabinet office minister, urged the government to maintain the "goodwill generated" between the government and the victims of the scandal.
Number of people taking ADHD medication at a record high
Latest statistics from the NHS Business Services Authority have shown that the number of people taking ADHD medication in England is at a record high.
From April 2023 to March 2024, around 278,000 patients were taking central nervous system stimulants and other drugs to treat their ADHD.
Clinical adviser on neurodiversity for the Royal College of GPs, Dr Heidi Phillips, credited the rise to "increased awareness" of symptoms and the fact that an "increased number of health professionals" are "issuing prescriptions".
It was yesterday reported that at least 196,000 adults are on ADHD waiting lists across the UK.
