Analysis ‘The number of nurses has gone up in hospitals in the last few years,’ he says. ‘We have seen an increase in health visitors too, and a big focus on safe staffing levels. ‘But another way to look at it is that staff levels were cut in the early years of the coalition, and there has been a fall in the number of people working elsewhere in the NHS, in the community for example. So both sides can try to make capital out of it.’ Some of this discussion about nursing numbers will be wrapped up in a debate about patient safety, a topic to which health secretary Jeremy Hunt often returns, particularly following the Mid Staffordshire public inquiry and the subsequent reports and measures that have been put in place.
Voters position health service at top of the election agenda Political parties are promising more funding, safer staffing levels and integrated care, writes Nick Triggle THE GENERAL election next month looks set to be one of the closest in recent times. After five years of coalition government, all three main political parties in England could be said to have realistic aspirations about being in power, or at least sharing it. The rise of the UK Independence Party (UKIP), strength of the Scottish National Party and Plaid Cymru, and the continued presence of contenders such as the Green Party, also mean a wider range of voices will be heard than normal. But what does this mean for the NHS? Results from a survey for the BBC by Populus, published in January, found that the health service is considered the most important issue for voters, even coming ahead of the economy. Funding looks certain to be a major topic, with many of the parties already committed to providing more money for the health service. The Tories highlighted in the last election that they would protect the NHS budget and have done so again. In his autumn statement, 8
April 2015 | Volume 22 | Number 1
chancellor George Osborne announced an extra £2 billion for 2015/16 and the party has said it will ‘protect and increase’ the budget in the years after that. Labour has promised an extra £2.5 billion a year on top of Tory spending plans, to be funded partly by a new ‘mansion tax’. Meanwhile, the Liberal Democrats have said they will ensure the NHS has the extra £8 billion a year that NHS England chief executive Simon Stevens says is needed by 2020. Meanwhile, UKIP has promised an extra £3 billion a year. Nuffield Trust chief executive Nigel Edwards says: ‘Money is already looking like it will be the big issue, but the promises are a bit vague. There is some doubt whether the Labour rises will kick in straight away, for example. We need more clarity about these pledges.’ And promises of extra money beg the question: what will the funds be spent on? RCN head of policy Howard Catton says staff numbers, particularly nurses, will be at the top of the agenda.
Joint working Mr Catton says there is also likely to be discussion about joining up heath and social care. Indeed Labour, which has unveiled the most detailed health plans so far, at least by the time Nursing Management went to press, has talked about creating integrated care organisations that will be responsible for local services. Meanwhile, the Conservatives want to build on the £5.3 billion Better Care Fund, and the Liberal Democrats plan to create pooled budgets locally by 2018. And this was all before agreement was reached at the end of February with NHS and local government officials in Greater Manchester about their plans for a shared budget. Twenty three health and care organisations, including the Royal College of Nursing, have put their names to a document calling for an ‘honest and bold’ debate about the future of health and care. The 2015 Challenge cites the integration agenda as one of the four priorities alongside preventable illnesses, mental health and the need to avoid another ‘top-down, large-scale’ reorganisation. Rob Webster, chief executive of the NHS Confederation, which brought together the coalition of bodies, says the next government must ‘put in place the right conditions’ so that those leading the health service can succeed. ‘As the election approaches, we need all candidates to play their part in a constructive debate,’ he says. NURSING MANAGEMENT
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Analysis
Conservatives ■ An extra £2 billion to be invested in the NHS next year and the budget to be protected and increased thereafter. ■ Everyone to have access to a GP seven days a week by 2020. Green Party ■ Introduce a dedicated NHS tax to go direct to the health service. ■ Abolish prescription charges and stop privatisation of NHS services. Labour ■ Recruit 20,000 more nurses, 8,000 GPs, 5,000 home care workers and 3,000 midwives. ■ Create integrated care bodies by making hospitals, GPs and councils collaborate. Liberal Democrats ■ Pooling of health and care budgets by 2018 so services are better co-ordinated. ■ Major emphasis on mental health including guarantees on waiting times. UK Independence Party ■ An extra £3 billion a year for the NHS, some to be spent on ending hospital parking charges. ■ Cut back on managers and give more power to senior nurses and matrons. Health Foundation chief economist Anita Charlesworth agrees, but warns: ‘The way care is provided needs to change and we must consider how to pay for that. But the election campaign is not necessarily the best place to have that debate. Politicians are under pressure, and that is not always conducive to the honesty and collaboration required.’
Savile review urges NHS to tighten its patient safety procedures Recommendations include more security policies, checking of volunteers and safeguarding strategies, finds Nick Triggle THERE ARE ‘many elements’ of Jimmy Savile’s involvement with the health service that could be repeated in the future, a report has warned. The conclusion comes from barrister Kate Lampard after she reviewed the 44 investigations into his behaviour at NHS sites. Her report, Themes and Lessons Learnt from NHS Investigations into Matters Relating to Jimmy Savile, acknowledges that Savile got away with so many sexual crimes for so long, nearly 50 years, largely because of the nature of society during that time. It cites factors such as social attitudes, less intrusive media and a more hierarchical structure in hospitals. But the report is clear: this does not mean that those running the modern health service can be complacent. The document lists several areas of concern: ■ Security and access arrangements for celebrity and VIP visits are too lax, so formal policies need to be established in all healthcare sites. ■ Arrangements for volunteer schemes vary widely; all volunteers, and staff, should be checked against barred lists, which should be refreshed every three years. ■ Safeguarding procedures should be tightened up; NHS organisations need to improve engagement with local safeguarding boards and ensure staff receive good training that is repeated regularly. Rex
Where the parties stand
Nick Triggle is a freelance journalist
■ Whether the NHS has the right safeguards to protect children and young people from negative aspects of the internet and social media is open to question, so all organisations must develop relevant policies. ■ The status of third-party contractors, particularly common in areas such as estates and security, is a weakness. Such contractors need to undergo appropriate checks and training. ‘The story of Jimmy Savile’s offending in NHS hospitals is unusual to the point of being scarcely credible,’ says Ms Lampard. ‘Nevertheless, many features have relevance and implications for today’s health service. ‘At the heart of the concerns raised by the Savile story is the failure of NHS organisations to keep patients, visitors and staff safe.’ The report has already been endorsed by health secretary Jeremy Hunt, who calls it ‘thoughtful and comprehensive’. He accepts many of the recommendations, though stops short of agreeing that all volunteers should be checked against barred lists, saying that this could ‘hold back the work of the NHS’s true heroes’. Instead, he says all people carrying out ‘regulated activity’, typically those with close and unsupervised contact with patients, should undergo the checks. He adds that the government will consult on introducing legislation to make it mandatory for staff to report abuse of children and vulnerable adults. Mr Hunt has asked healthcare regulator Monitor and the Trust Development Authority to ensure that all trusts review current practices in the next three months. ‘Our NHS will be made safer for thousands of children and vulnerable adults as we learn the uncomfortable lessons from this terrible tragedy,’ he says. Nick Triggle is a freelance journalist
Find out more
Find out more
The 2015 Challenge: Our Prescription for the Election can be downloaded at tinyurl.com/plj8337
To read Themes and Lessons Learnt from NHS Investigations into Matters Relating to Jimmy Savile, go to tinyurl.com/otz3d2t
NURSING MANAGEMENT
Jimmy Savile’s behaviour went unchecked for decades
April 2015 | Volume 22 | Number 1
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9
Voters position health service at top of the election agenda Political parties are promising more funding, safer staffing levels and integrated care, writes Nick Triggle THE GENERAL election next month looks set to be one of the closest in recent times. After five years of coalition government, all three main political parties in England could be said to have realistic aspirations about being in power, or at least sharing it. The rise of the UK Independence Party (UKIP), strength of the Scottish National Party and Plaid Cymru, and the continued presence of contenders such as the Green Party, also mean a wider range of voices will be heard than normal. But what does this mean for the NHS? Results from a survey for the BBC by Populus, published in January, found that the health service is considered the most important issue for voters, even coming ahead of the economy. Funding looks certain to be a major topic, with many of the parties already committed to providing more money for the health service. The Tories highlighted in the last election that they would protect the NHS budget and have done so again. In his autumn statement, 8
April 2015 | Volume 22 | Number 1
chancellor George Osborne announced an extra £2 billion for 2015/16 and the party has said it will ‘protect and increase’ the budget in the years after that. Labour has promised an extra £2.5 billion a year on top of Tory spending plans, to be funded partly by a new ‘mansion tax’. Meanwhile, the Liberal Democrats have said they will ensure the NHS has the extra £8 billion a year that NHS England chief executive Simon Stevens says is needed by 2020. Meanwhile, UKIP has promised an extra £3 billion a year. Nuffield Trust chief executive Nigel Edwards says: ‘Money is already looking like it will be the big issue, but the promises are a bit vague. There is some doubt whether the Labour rises will kick in straight away, for example. We need more clarity about these pledges.’ And promises of extra money beg the question: what will the funds be spent on? RCN head of policy Howard Catton says staff numbers, particularly nurses, will be at the top of the agenda.
Joint working Mr Catton says there is also likely to be discussion about joining up heath and social care. Indeed Labour, which has unveiled the most detailed health plans so far, at least by the time Nursing Management went to press, has talked about creating integrated care organisations that will be responsible for local services. Meanwhile, the Conservatives want to build on the £5.3 billion Better Care Fund, and the Liberal Democrats plan to create pooled budgets locally by 2018. And this was all before agreement was reached at the end of February with NHS and local government officials in Greater Manchester about their plans for a shared budget. Twenty three health and care organisations, including the Royal College of Nursing, have put their names to a document calling for an ‘honest and bold’ debate about the future of health and care. The 2015 Challenge cites the integration agenda as one of the four priorities alongside preventable illnesses, mental health and the need to avoid another ‘top-down, large-scale’ reorganisation. Rob Webster, chief executive of the NHS Confederation, which brought together the coalition of bodies, says the next government must ‘put in place the right conditions’ so that those leading the health service can succeed. ‘As the election approaches, we need all candidates to play their part in a constructive debate,’ he says. NURSING MANAGEMENT
Downloaded from RCNi.com by ${individualUser.displayName} on Nov 29, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
Analysis
Conservatives ■ An extra £2 billion to be invested in the NHS next year and the budget to be protected and increased thereafter. ■ Everyone to have access to a GP seven days a week by 2020. Green Party ■ Introduce a dedicated NHS tax to go direct to the health service. ■ Abolish prescription charges and stop privatisation of NHS services. Labour ■ Recruit 20,000 more nurses, 8,000 GPs, 5,000 home care workers and 3,000 midwives. ■ Create integrated care bodies by making hospitals, GPs and councils collaborate. Liberal Democrats ■ Pooling of health and care budgets by 2018 so services are better co-ordinated. ■ Major emphasis on mental health including guarantees on waiting times. UK Independence Party ■ An extra £3 billion a year for the NHS, some to be spent on ending hospital parking charges. ■ Cut back on managers and give more power to senior nurses and matrons. Health Foundation chief economist Anita Charlesworth agrees, but warns: ‘The way care is provided needs to change and we must consider how to pay for that. But the election campaign is not necessarily the best place to have that debate. Politicians are under pressure, and that is not always conducive to the honesty and collaboration required.’
Savile review urges NHS to tighten its patient safety procedures Recommendations include more security policies, checking of volunteers and safeguarding strategies, finds Nick Triggle THERE ARE ‘many elements’ of Jimmy Savile’s involvement with the health service that could be repeated in the future, a report has warned. The conclusion comes from barrister Kate Lampard after she reviewed the 44 investigations into his behaviour at NHS sites. Her report, Themes and Lessons Learnt from NHS Investigations into Matters Relating to Jimmy Savile, acknowledges that Savile got away with so many sexual crimes for so long, nearly 50 years, largely because of the nature of society during that time. It cites factors such as social attitudes, less intrusive media and a more hierarchical structure in hospitals. But the report is clear: this does not mean that those running the modern health service can be complacent. The document lists several areas of concern: ■ Security and access arrangements for celebrity and VIP visits are too lax, so formal policies need to be established in all healthcare sites. ■ Arrangements for volunteer schemes vary widely; all volunteers, and staff, should be checked against barred lists, which should be refreshed every three years. ■ Safeguarding procedures should be tightened up; NHS organisations need to improve engagement with local safeguarding boards and ensure staff receive good training that is repeated regularly. Rex
Where the parties stand
Nick Triggle is a freelance journalist
■ Whether the NHS has the right safeguards to protect children and young people from negative aspects of the internet and social media is open to question, so all organisations must develop relevant policies. ■ The status of third-party contractors, particularly common in areas such as estates and security, is a weakness. Such contractors need to undergo appropriate checks and training. ‘The story of Jimmy Savile’s offending in NHS hospitals is unusual to the point of being scarcely credible,’ says Ms Lampard. ‘Nevertheless, many features have relevance and implications for today’s health service. ‘At the heart of the concerns raised by the Savile story is the failure of NHS organisations to keep patients, visitors and staff safe.’ The report has already been endorsed by health secretary Jeremy Hunt, who calls it ‘thoughtful and comprehensive’. He accepts many of the recommendations, though stops short of agreeing that all volunteers should be checked against barred lists, saying that this could ‘hold back the work of the NHS’s true heroes’. Instead, he says all people carrying out ‘regulated activity’, typically those with close and unsupervised contact with patients, should undergo the checks. He adds that the government will consult on introducing legislation to make it mandatory for staff to report abuse of children and vulnerable adults. Mr Hunt has asked healthcare regulator Monitor and the Trust Development Authority to ensure that all trusts review current practices in the next three months. ‘Our NHS will be made safer for thousands of children and vulnerable adults as we learn the uncomfortable lessons from this terrible tragedy,’ he says. Nick Triggle is a freelance journalist
Find out more
Find out more
The 2015 Challenge: Our Prescription for the Election can be downloaded at tinyurl.com/plj8337
To read Themes and Lessons Learnt from NHS Investigations into Matters Relating to Jimmy Savile, go to tinyurl.com/otz3d2t
NURSING MANAGEMENT
Jimmy Savile’s behaviour went unchecked for decades
April 2015 | Volume 22 | Number 1
Downloaded from RCNi.com by ${individualUser.displayName} on Nov 29, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
9
