4th December 2015

• BMA suspends strike action following talks with the Government
• Health Select Committee calls for urgent Government action on childhood obesity
• Rising waiting times and missed targets in Northern Ireland
• Welsh Government outlines NHS Wales winter plans
• Wales introduces soft opt-out system for organ donation
• NHS England appoints three new national leads

BMA suspends strike action following talks with the Government

Ahead of planned industrial action by junior doctors this week, five days of conciliatory talks between the BMA and the Government ended with strikes being suspended, and the threat of contract imposition being withdrawn. Agreement reached through the Advisory, Conciliation and Arbitration Service (ACAS) allows for time-limited contract negotiations to take place, under the condition that strike action and unilateral imposition of a new contract by the Government are withheld. NHS Employers also agreed to extend the BMA’s industrial action mandate to allow the trade union to commence any strike action up to 13th January 2016. The Government’s pre-ballot offer to junior doctors will form the agreed basis of negotiations.

In a statement to the House of Commons, Health Secretary, Jeremy Hunt MP, said: “Whether or not there is a strike, providing safe services for patients will remain the priority of this Government”. Responding to the agreement, Chair of the BMA Junior Doctors Committee, Johann Malawana, said: “We have received assurances that we sought, particularly around the safety of current and future junior doctors and the patients they care for. It is positive that the concerns of junior doctors have now been listened to, so that all sides can return to the negotiating table”. In response, the College welcomed the news which ‘is in patients’ interests’.

Health Select Committee calls for urgent Government action on childhood obesity

On Monday, the Commons Health Select Committee published the report Childhood obesity—brave and bold action. The Committee recommended urgent measures to tackle both children’s obesity and dental health, including a sugary drinks tax, restrictions on price promotions and advertising of unhealthy food and drinks; and a reformulation programme to reduce sugar in food and drink. Many of the recommendations supported Public Health England’s recent report, Sugar reduction: the evidence for action.

Amongst those giving evidence to the inquiry that led to the report was the celebrity chef Jamie Oliver. To coincide with the publication of the report, the Petitions Committee scheduled a debate on a petition started by Mr Oliver on a sugary drinks tax. Despite the lengthy debate, the Government responded saying they “have no plans to introduce a sugar tax, although all taxes are kept under review”.

The report comes ahead of the government’s obesity strategy that is expected early next year. The Faculty of Dental Surgery is continuing to call for children’s oral health to be addressed in the obesity strategy following our reports The state of children’s oral health in England and Actions for the government to improve oral health, that highlighted the high number of children being admitted to hospital for tooth decay. 

Rising waiting times and missed targets in Northern Ireland 

The Northern Ireland Department of Health, Social Services and Public Safety (DHSSPS) has published quarterly waiting times statistics this week for inpatient admissions, outpatient appointments and diagnostic tests, covering June-September 2015. Waiting times both for inpatient admissions and outpatient appointments have risen steadily and noticeably since September 2013 and figures show significant year-on-year increases in numbers.

Of the total number of patients on the inpatient admission waiting list (62,697), 22% were waiting to be admitted for general surgery, and 18% were waiting for trauma and orthopaedic surgery, which were the two top specialties for numbers of patients waiting. Four out of Northern Ireland’s five Health and Social Care Trusts missed the target of 65% of patients waiting no longer than 13 weeks for inpatient admission, and every Trust missed the maximum waiting time target of 26 weeks. The number of patients waiting longer than 26 weeks increased by 178% between September 2014 and September 2015, from 6,519 to 18,137.

At the end of September 2015, 230,625 patients were waiting for a first outpatient appointment, representing a 48% increase from the same time in 2014. General surgery and trauma and orthopaedic surgery were again the specialties with the longest waiting lists. Every HSC Trust missed both waiting time targets of 60% of patients waiting no longer than 9 weeks for a first outpatient appointment, and no patient waiting longer than 18 weeks. Of the total number of patients waiting, 48% were waiting longer than 18 weeks, having risen significantly from the 18% recorded in September 2014.

Welsh Government outlines NHS Wales winter plans

The Welsh Government has this week outlined integrated winter plans developed by health boards, NHS trusts, the Welsh Ambulance Service and local councils. NHS staff are now working to implement the planning arrangements to prepare for peaks in pressure over the winter months.
 
Key measures include:

• Identifying extra beds in response to an increase in demand, while at the same time each reducing occupancy by avoiding admissions, reducing lengths of stay and supporting discharges.
• Reducing hospital admissions by increasing the use of minor injury units, working with GP out of hours services for patients.
• Reducing the length of stay for patients by increased consultant cover, fewer delayed transfers of care, improved patient transport arrangements and increased use of discharge lounges.
• Increasing seven-day working strengthened senior management and clinical presence, including therapists and social workers, to ensure all key services remain open through the Christmas and New Year period.

Welsh Ministers are also investing £20m a year in the Intermediate Care Fund, which supports schemes which improve out-of-hospital care and help people return home from hospital.

Wales introduces soft opt-out system for organ donation

On Tuesday, Wales’ new soft opt-out organ donation policy was brought into force. The policy is one of ‘presumed consent’, whereby a patient’s organs, if suitable for donation, are donated after their death unless they have explicitly opted out. The policy is described as a ‘soft’ opt-out system because relatives are able to veto a decision for the patient’s organs to be donated. It only applies to over 18s.

The policy has been introduced following the passing of the Human Transplantation (Wales) Bill in 2013. In the lead up to its introduction, the Welsh Government has been running a campaign to inform the public of the new policy.

An opt-out policy has been introduced in other European countries including Spain, Sweden and Austria, but the evidence on the effect of an opt-out system on donation rates is not clear cut.

NHS England appoints three new national leads

New national leads have been announced this week for urgent and emergency care, patients and public participation and insight, and commissioning operations and information.

Matthew Swindells, former Director General at the Department of Health and Cabinet Office health team lead, will begin his new role as National Director for Commissioning Operations and Information in late spring 2016. In addition to his prominent roles in Government, he was previously Chief Executive of hospitals including Royal Surrey County, Guys and St Thomas’ hospitals, and Heatherwood and Wexham Park, following a career in NHS management. He is currently Managing Director for Population Health with health technology company Cerner.

Pauline Philip has been named as the new National Urgent and Emergency Care Director to ensure the delivery of Professor Sir Bruce Keogh’s Urgent and Emergency Care Review. Following a career as a nurse, she is currently Chief Executive of Luton and Dunstable University Hospital Foundation Trust, and will remain in this role while being seconded to NHS England.

Anu Singh recently started her new role of National Director of Patient and Public Participation and Insight, joining from Staffordshire County Council, where she was Head of Business Improvement, and is also a Non-Executive Director of the Whittington Integrated Care NHS Trust.