NHS pressures undermining relations between doctors and managers

A new survey of hospital managers and senior doctors finds signs that they are working together better than in the past, but warns relations have been damaged by reorganisation and financial pressures | Nuffield Trust


The poll of 472 leaders and clinicians in management roles is published today in the Nuffield Trust report Managing doctors, doctors managing, along with results from interviews, a focus group and a review of academic literature. It finds that 60% now believe local doctor-manager relationships are positive, up from 47% in a 2002 study, and respondents are now more confident that managers put patient care first. However, a higher proportion of respondents (37%) now believe relations are likely to deteriorate over the coming year, compared to only 13% in 2002.

Read the overview here

Read the full report here

Centre for Mental Health: Annual Review for 2015/16

Centre for Mental Health has today launched its Annual Review for 2015/16.

Image source: CMH

In the review, we look back at our impact over the last year, from helping to secure a £1 billion investment through the Five Year Forward View strategy, to analysing the accounts of people with lived experience of mental health problems. We’ve been continuing our untiring work to improve mental health services for children, highlighting the 10-year gap children face between first experiencing symptoms and actually receiving treatment. And we’ve been pioneering new areas of work, such as exploring the links between mental health and housing.

Read an overview of the report here

Read the full report here

The failure of privatised adult social care in England | @CHPIthinktank

This report looks at the growth in the market in adult social care in England and the problems which have resulted from this | CHPI

Image source: CHPI

In order to address the failures of market provision the report looks at three possible options – ‘‘market shaping’, ‘‘market regulation’’ and ‘‘replacing the market’’. Whilst the Care Act 2014 provides local authorities with powers and duties to ‘‘shape’’ the market locally in order to achieve better outcomes this remains unachievable, given the current budget restrictions and the heavy reliance of local authorities on private providers to deliver services. Market regulation has been the approach adopted by the government, and the recent introduction of a market oversight role for the Care Quality Commission – to identify private care home providers which may be facing financial collapse – is an acknowledgement of the precarious nature of the care home market. But it provides no powers for the regulator to intervene to prevent a company.

Read the full report here

Alcohol evidence review

Public Health England has published a comprehensive review of the evidence on alcohol harm and its impact in England. It examines alcohol’s health, social and economic impact, and the effectiveness of actions in reducing its harms.


Alcohol is now more affordable and people are drinking twice as much as they did 40 years ago. The economic burden of health, social and economic alcohol-related harm is substantial, with estimates placing the annual cost to be between 1.3% and 2.7% of annual GDP. Alcohol related deaths affect predominantly young and middle aged people; as a result alcohol is a leading cause of years of working life lost in England.

The review provides national and local policy makers with the latest evidence to identify those policies which will best prevent and reduce alcohol-related harm. It details policies that impact directly on the environment in which alcohol is sold and marketed, including its price, availability and advertising along with policies directed at people most at risk.

Other findings from the review include:

  • most adults in England drink alcohol – more than 10 million people are drinking at levels that increase the risk of harming their health
  • 5% of the heaviest drinkers account for one third of all alcohol consumed
  • alcohol is the leading cause of death among 15 to 49 year olds and heavy alcohol use has been identified as a cause of more than 200 health conditions
  • alcohol caused more years of life lost to the workforce than from the 10 most common cancers combined – in 2015 there were 167,000 years of working life lost
  • the evidence strongly supports a range of policies that are effective at reducing harm to public health while at the same time reducing health inequalities – reducing the affordability of alcohol is the cost effective way of reducing alcohol harm

Read the full report: The public health burden of alcohol: evidence review

Enablers and challenges to inclusion for disabled children, young people and their families

The report reflects the views of 10 young people, 123 parent carers of disabled children and adults and 128 professionals and volunteers who responded to the Disability Matters ‘call for evidence’ earlier this year | RCPCH

The report, ‘Disability Matters in Britain 2016: Enablers and challenges to inclusion for disabled children, young people and their families,’ pulls together the views and experiences of disabled children, young people and their parents or carers with the aim of raising awareness of good practice being adopted already, encouraging others to follow their lead and to help ensure that disabled people of all ages are valued as equals in our communities.

Read an overview of the report here

Read the full report here

RPS standards for reporting and learning for incidents

The Royal Pharmaceutical Society has published Professional standards for the reporting, learning,  sharing, taking action and review of incidents.

These standards describe good practice and good systems of care for reporting, learning sharing, taking action and review of incidents as part of a patient safety culture. Their implementation will improve patient safety and the quality of pharmaceutical services.

Image source: http://www.rpharms.com/

Reform of care for people with long term conditions

The Royal Pharmaceutical Society England has published Frontline pharmacists: making a difference for people with long term conditions.

Image source: http://www.rpharms.com/

This report focuses on the need to enhance the role of pharmacists as part of a multidisciplinary approach to help tackle the challenges facing the NHS in treating and supporting people living with long term conditions.

One in three people in England (15 million) have a long term condition , such as such as diabetes or asthma, and this is set to rise to at least 18 million people by 2025 .  Their care currently accounts for 50% of all GP appointments, 64% of all outpatient appointments 70% of all health and social care spending.
The average health and social care cost per person per year rises with the number of long term conditions they have, from just over £1,000 for someone without a condition, to around £3,000 for someone with one condition and up to nearly £8,000 for someone living with three or more long term conditions.
The RPS is calling for a change in policy regarding the training of prescribers to enable more pharmacists to become prescribers. This means they could take on the management of patients whose condition is stable but require regular monitoring and alteration of their medicines to stay well, so keeping them out of hospital or GP surgeries.
Additional link: RPS News release

Diabetes UK nursing survey


Diabetes UK has published Diabetes specialist nursing 2016 workforce survey: a workforce in crisis.   This survey found that nearly four out of five Diabetes Specialist Nurses (78%) voiced concerns that their workload is having an impact on patient care and/or safety and almost four in ten respondents (39%) said they considered their current caseload ‘unmanageable’.

Additional link: Royal College of Nursing

NICE: Women with family history of breast cancer should take pill

Hundreds of thousands of healthy women should take pills to cut their risk of breast cancer, says NHS watchdog NICE | BBC News


The draft guidelines for England say women predisposed to breast cancer because of a strong family history of the disease need this protection.

There are now three drugs to choose from – tamoxifen, raloxifene and, for the first time, anastrozole. Anastrozole is cheaper than the other two and, for some women, has fewer side-effects and is more effective.

Read the full news story here

Read the NICE draft guidelines here

Details of new A&E waiting targets for trusts | via @HSJnews

New guidance, seen by HSJ, sets out what is expected of mental health and acute trusts to meet the new emergency access and waiting time targets.


  • All emergency and urgent mental health patients in A&E and hospital wards should be seen within one hour by liaison psychiatry staff
  • Emergency patients should be treated within four hours and urgent patients within 24 hours
  • Trusts to submit how quickly they respond to emergency mental health crises at hospitals from April
  • New guidance tells trusts to report if they are hitting emergency and urgent mental health liaison target

Read the full news story here