On 22 March, the Health and Social Care Committee held an oral evidence session for their Workforce: recruitment, training and retention in health and social care inquiry.
Professor Dame Clare Gerada. Medical Director, NHS Practitioner Health and Chair, Doctors in Distress, spoke at the session.
Dr Gerada began by noting more doctors had contacted Doctors in Distress during the pandemic than had done so in the organisation’s first 10 years. This amounted to 5,000 people, of which up to 70% were GPs. Among several comments, Dr Gerada claimed that ‘burnout’ is too gentle a term for what NHS staff are experiencing, with the system exploiting the goodwill of staff while not being able to look after them properly. Her solution to this involved setting up a body similar to the CQC, which would independently set standards and hold to account the NHS for workforce wellbeing issues. She is also lobbying for a contracted reflection hour once a month for all staff.
On 16 March, Dr Andrew Murrison, Conservative MP for South West Wiltshire, proposed a new bill to ‘make provision about expediting the transfer of patients who are medically fit for discharge from acute hospitals to homely settings in the community’.
Mr Murrison noted that there is severe congestion in health and social care at present. He argued that ‘modern district general hospitals’ are not suitable for the long-term care of elderly or terminal patients, but despite this they are used for that purpose. Better settings are ‘community hospitals and intermediate care’ which have been ‘foolishly… deprioritised under successive Governments’.
The MP asserted that ‘the care pathway must lead frail elderly people to homely settings in the community that are appropriate to their needs, without delay’. Among other measures, Mr Murrison’s proposed bill would establish delayed discharge as a patient safety issue and would require delayed discharge data to be published in a league table of NHS trusts and integrated care partnerships.
The bill was supported in the Commons by former Health Minister Steve Brine, GP and Health Select Committee Dr Luke Evans, and Consultant Paediatrician Dr Caroline Johnson.
On 15 March, Andrew Selous, Conservative MP for South West Bedfordshire, led a debate in the House of Commons on the subject of physical activity and health outcomes.
Mr Selous noted regular physical activity reduces the risk of numerous conditions and diseases, including hip fractures, depression and a range of cancers.
The MP highlighted statistics from the Royal College of General Practitioners, who have found that 34% of men and 42% of women in the UK are not active enough, and physical inactivity is responsible for one in every six UK deaths. Mr Selous went on to quote Justin Varney, Director of Public Health in Birmingham, who has claimed that “the whole concept of an NHS and welfare state is completely unsustainable if a third or more of the population remain physically inactive.”
On 10 March, Sir Bob Neill, Conservative MP for Bromley and Chislehurst, led a Westminster Hall debate on people with deteriorating long-term health conditions during the covid-19 pandemic.
Sir Bob began by noting there are ‘hundreds of thousands, if not millions, of people’ in the UK with long-term conditions, who have been acutely affected by the pandemic – both in terms of physical and mental health.
The MP made several references to community rehabilitation services, which saw many of their staff being redeployed elsewhere during the pandemic. Sir Bob called for national and local rehabilitation strategies for getting these services back to where they were pre-Covid. He argued rehabilitation would reduce visits to GPs, the number of delayed discharges, and demand for acute care.
Sir Bob acknowledged that workforce was a real problem, with ‘allied health professional representative bodies all saying that they are willing to step up to the plate, but they need the numbers.’
Also on 10 March, Elliot Colburn, Conservative MP for Carshalton and Wallington, led a Westminster Hall debate on NHS support for prostate Cancer patients.
Mr Colburn noted that the pandemic has resulted in fewer men coming to their GP to get tested for prostate cancer. He compared the referral rate for prostate cancer – 80% of pre-pandemic levels -with those for other forms of cancer, with breast cancer operating at 120% of pre-pandemic levels.
The MP mentioned the new London Cancer Hub in his constituency, which he said would lead to greater access to diagnosis and treatment and increased use of technology.
On 8 March, the Health and Social Care Secretary Sajid Javid delivered a speech on healthcare reform at the Royal College of Physicians, London.
Mr Javid began by thanking health workers, including GPs, for putting ‘everything on the line to care for people’ during the pandemic.
The Minister asserted his philosophical views on health, stating that individuals have a responsibility for the health of ‘fellow citizens’ and that he ‘believes in’ the NHS. He defined the NHS as a world-class healthcare system, free at the point of use and paid for with general taxation.
He argued that coming out of the pandemic was the ideal opportunity to reform the service, but he also noted that predictions that two-thirds of adults over 65 will live with multiple health conditions by 2035 made it a necessity. Meeting the public’s high expectations, especially with such high backlogs, was also suggested to justify change, with Mr Javid stating that more than a million people speak with their GP every day.
These reforms would not, however, simply be financial investment – the Minister made the point that a computer can be built to be ten thousand times more powerful, but a doctor can never be able to treat ten thousand times more patients. Mr Javid claimed that his reforms were desired by NHS workers, and would provide them with more freedom in the delivery of care.
The first ‘shift’ announced in the speech was an increased focus on prevention, to reduce the ‘vast sums’ the NHS spends on treating avoidable conditions. Mr Javid acknowledged that GPs will be central to this plan, as primary care is one of the best ways to prevent and manage illnesses locally. Community Diagnostic Centres will also be heavily involved in the plan. Relatedly, the Minister mooted a sustainable vaccination service that doesn’t ‘displace other health and care services’.
Another innovation described was to give the public more power over their own health, with a new ‘right to choose’ and an aim to focus on people as a whole rather than as a sufferer of various, unrelated conditions. Mr Javid argued that the ability to choose would lessen health disparities.
Disparities in confidence to interact with online health services would also be addressed by a digital future for the NHS ‘that works for everyone’. It was noted that remote GP appointments were a symbol of this digital future. The adoption of more digital practices could improve the patient experience and ‘free up more time for GPs’.
Towards the close of his speech, Mr Javid referred to two London health bodies, the South West London Elective Orthopaedic Centre, and the South London Health and Community Partnership, as models for the entire country. He also mentioned a forthcoming, ‘proper’, long-term workforce plan.