General Practice Planning Guidance for 2017/18 and 2018/19 Published

Delivering the Forward View: NHS Operational Planning Guidance for 2017/18 and 2018/19 has been published by NHS England and NHS Improvement. The document provides NHS trusts and commissioners with the tools they need to plan for the years.

On top of already announced increases to primary medical care allocations for general practice, the guidance confirms that there will also be further local recurrent funding to improve and increase capacity in general practice, totalling £138m by 2017/18 and increasing to £258m by 2018/19 (part of the wider commitment to invest an extra £2.4 billion in general practice services by 2020/21).

• In 2016/17 the additional funding will be restricted to:
• Practices involved in the General Practice Access Fund pilot scheme (formerly known as the Prime Minister’s Challenge Fund)
• A number of additional areas across the country which will accelerate delivery of improving GP access in 2017/18. 
• A London wide programme of improving access from 2016/17.The investment will be extended in 2018/19 to enable the whole country to start developing additional capacity, so that from April 2019 every CCG can expect a minimum additional £6 per head to improve access to general practice.

For the first time, the new planning guidance also places a requirement on CCGs to develop local action plans detailing how they will deliver on the aims set out in the General Practice Forward View (as part of their Sustainability and Transformation Plans). In particular, the plans will need to set out how CCGs will invest funds to support and transform general practice.
CCGs need to provide plans outlining their approach to implementing the General Practice Forward View by 23 December 2016.

Arvind Madan, NHS England’s Director of Primary Care, said: “We know that general practice is under pressure and we are determined to maintain the momentum in turning things around, as started with the launch of the General Practice Forward View. Today’s planning guidance, with detail on how investment will look in the coming years, demonstrates the steps we will be taking with CCGs to both stabilise and transform GP services in the years to come.”

“CCGs will be able to commission extra services, making the most of new technologies and the wider workforce. This might include commissioning provision of access to pre-bookable and same day appointments to general practice services in evenings (after 6:30pm) and at weekends, meeting local population needs as appropriate. This should help reduce demand on both general practice in-hours, and urgent care services.”

King’s Fund Calls for Credible Digital Health Plan with Appropriate Levels of Funding

Government ministers and NHS leaders should set out a definitive plan for expanding the use of digital technology in the health service, according to a new briefing published by The King’s Fund.

The briefing highlights the risk of losing credibility and commitment among frontline NHS staff if the digital health agenda continues to be subject to shifting priorities, new initiatives and slipping timescales. It calls for urgent clarification of when funding already announced will be made available, warning that holding back investment until later in the parliament will inevitably slow down progress.

The briefing assesses progress made against key commitments including:

• The implementation of electronic patient record.
• Increasing the number of accredited health apps.
• Rolling out online appointment booking and repeat prescription services.

It concludes that digital technology has the potential to deliver significant benefits to patients and health professionals but that progress in implementing it is patchy.

The report goes on to criticise the level of funding available to support digital and technology projects in the NHS over the course of this parliament. Supporting the conclusion of the recent national review led by Professor Robert Wachter, that additional funding will be needed to achieve the government’s goals, as well as his call for a more realistic timetable for implementing the NHS digital agenda in acute hospitals, where most progress needs to be made.

Matthew Honeyman, policy researcher at The King’s Fund, said “Ministers and NHS leaders must articulate a clear and compelling vision which conveys the benefits of digitisation to the clinical staff who will be central to implementing it and provide certainty about the funds available to support it.”

Social Publishing is Offering Authors a New Route to Market

Social Publishing is a publishing company with a difference, changing the rules of conventional publishing by including a social element.

The company will be editing and publishing ebooks and paperbacks in the traditional manner, but how they will select their titles is quite different. Rather than a team of editors choosing which books to publish, Social Publishing’s online platform allows readers to make those choices.

Authors can upload parts of their manuscripts to the website and readers are given 5 votes per month to vote for the ones they would like to see published. When a manuscript reaches an undisclosed vote threshold, the writer is contacted and awarded a publishing contract.

Whether you get a contract or not, this outlet offers authors a platform to share their passions, gain recognition and followers.

Visit Social Publishing to find out more at https://social-publishing.co.uk/

CQC Updates Code of Practice on Confidential Personal Information

The CQC’s Code of Practice on Confidential Personal Information covers the sharing of personal information held by the CQC and the criteria set for deciding whether or not they need to look at medical care records during an inspection. 

Examples of confidential personal information covered by the policy:

·         A person’s medical or care records, or specific pieces of information about their physical or mental health, condition or treatments.

·         Information about a care provider’s social or family life.

·         Details of a care worker’s education, training and experience.

·         Information about the sexuality, religious beliefs and racial or ethnic origin of a CQC employee.

·         Information that would identify people who have shared information in confidence with the CQC, including people who use the services regulated by the CQC, ‘whistleblowers’, and people they have interviewed in private during inspections.

Earlier this year the CQC consulted on the code of practice and plans to update it.  They have now published a revised code in response to feedback received.

The revised code of practice recognises the most recent changes in legislation and ensures that CQC policy aligns with codes of practices on confidential information from NHS Digital and the Department of Health. It explains more clearly than before why the CQC needs to use confidential personal information and gives specific examples to show how the code will translate into action.

The updated code of practice can be found on the CQC’s privacy page.

Research Suggests Idea that Women Don’t Ask For Pay Rises is an Urban Myth

New research by University of Warwick, Cass Business School, City, University of London and the University of Wisconsin at Oshkosh, USA shows that women ask for wage rises just as often as men, but men are 25 per cent more likely to get a raise when they ask.

Using a randomly chosen sample of 4,600 workers across more than 800 employers, the research is the first to do a statistical test of the idea that women get paid less because they are not as pushy as men. The researchers found no support for the theory.

The authors of the study Do Women Ask? also examined the claim that female employees hold back for fear of upsetting their boss, and again found no evidence for this theory either.

Co-author Andrew Oswald, Professor of Economics and Behavioural Science at the University of Warwick said: “We didn’t know how the numbers would come out. Having seen these findings, I think we have to accept that there is some element of pure discrimination against women.”

Various ideas have previously been suggested as to why women might be reluctant to ask for an increase in their pay packet. These include: women don’t want to deviate from a perceived female stereotype, and they may fear being less popular at work.

Co-author Dr Amanda Goodall at Cass Business School said: “Ours is the first proper test of the reticent-female theory, and the evidence doesn’t stand up.”

When like-for-like men and women were compared, the men were a quarter more likely to be successful, obtaining a pay increase 20 per cent of the time. Only 16 per cent of females were successful when they asked.

The research uses data gathered in the Australian Workplace Relations Survey (AWRS) which covers the period 2013-14 which is a representative sample of Australian employees and workplaces. Professor Oswald said: “We realised that Australia was the natural test bed, because it is the only country in the world to collect systematic information on whether employees have asked for a rise.”

The survey has the distinctive feature that it asks individuals a set of questions about whether their pay is set by negotiation with the company, whether they have successfully obtained a wage rise since joining the employer, whether they preferred not to attempt to negotiate a pay rise because they were concerned about their relationships, why they decided that, and about their levels of job satisfaction.

Using statistical methods, the authors’ analysis shows that it is crucial to adjust for the number of hours worked (because part-time workers feel hesitant to ‘ask’). The analysis also took into account the nature of the employer, the industry, and the characteristics and qualifications of workers.

Despite the dispiriting findings, the authors pinpointed one encouraging sign in the data - young Australian female employees get pay hikes just as often as young Australian men.

Dr Goodall said: “This study potentially has an upside. Young women today are negotiating their pay and conditions more successfully than older females, and perhaps that will continue as they become more senior”.

The Publishers Association Post-Brexit Manifesto

The Publishers Association has set out the publishing industry’s key priorities for negotiations on the UK’s new relationship with the European Union, calling on the government to keep barriers to trade with the EU to an absolute minimum and to publish a clear plan to minimise business uncertainty.

The PA is also calling for the government to:

• Legislate to create stronger copyright rules to encourage investment in the UK and to protect creators 
• Ensure the UK research community remains a global leader by developing new strategies for domestic investment 
• Ensure publishers and businesses have access to the people and skills they need, whilst taking into account the public’s concerns about immigration 

The priorities reflect the main concerns the publishing industry highlighted in a survey conducted by the PA, which was responded to by major publishers across trade, education and academic publishing as well as many independent publishing houses.

Stephen Lotinga, Chief Executive of the Publishers Association, said: “The UK publishing industry is a great success both nationally and internationally, and it’s essential that our concerns are at the forefront of these Brexit negotiations to make sure our voice is heard and success is not taken for granted.

“This manifesto sets out the industry’s key priorities for the future, which include retaining access to the single market and ensuring that publishers continue to have access to the people and skills they need. There should also be no doubt that UK publishing will embrace the opportunities presented by leaving the EU, such as securing a stronger copyright framework. We will be meeting with Government departments, political parties, senior civil servants and key influencers in the coming months to discuss these priorities.”

Click here to view the manifesto in full.

District Nursing Crisis Could Affect Wider Social Care Sector

Unmanageable caseloads and shortages of staff in district nursing services are compromising quality of care for some patients according to a new report from The King’s Fund.

Although government policy is for more care to be delivered by these types of services, new research carried out for the report found district nursing at breaking point due to a profound and growing gap between capacity and demand.

Activity has increased significantly in recent years both in terms of the number of patients seen and the complexity of the care provided. Whilst the number of nurses working in community health services has declined over recent years, and the number working in senior ‘district nurse’ posts has fallen dramatically over a sustained period.

The report highlights that these pressures are compromising quality of care for some patients; the researchers found evidence of an increasingly task-focused approach to care, staff being rushed and abrupt with patients, reductions in preventive care, visits being postponed and lack of continuity of care.

Although some aspects of staff shortages are being managed well, services are generally over-stretched and heavily reliant on staff good-will. The researchers found that this is having a deeply negative impact on staff wellbeing, with unmanageable caseloads leading to fatigue, stress and in some cases ill health. They heard reports of staff being ‘broken’, ‘exhausted’ and ‘on their knees’, with some leaving the service as a result.

The report makes three key recommendations to address the problems in district nursing services:

• System leaders must recognise the vital strategic importance of community health services in realising ambitions for transforming and sustaining the health and social care system.
• There is an urgent need to create a sustainable district nursing workforce by reversing declining staff numbers, raising the profile of district nursing and developing it as an attractive career.
• Robust mechanisms for monitoring resources, activity and workforce must be developed alongside efforts to look in the round at the staffing and resourcing of community health and care services for the older population.

The report also found that staff, patients and carers have a strongly aligned view of what constitutes good quality care. It sets this out as a framework, which it argues should be developed for assessing and assuring the quality of care delivered in community settings.

Anna Charles, Policy Researcher at The King’s Fund said “At its best, district nursing offers an ideal model of person centred, preventive, community-based care. For years, health service leaders have talked about the importance of providing more care in the community, but this objective cannot be achieved when district nursing is at breaking point and a poverty of national data means the quality of services is not properly monitored.

“It is worrying that the people most likely to be affected by this are often vulnerable and also among those who are most likely to be affected by cuts in social care and voluntary sector services. It is even more troubling that this is happening ‘behind closed doors’ in people’s homes, creating a real danger that serious failures in care could go undetected because they are invisible.”

Commenting on the report Kathryn Yates, RCN Professional Lead for Primary and Community Care said “It’s two years since the RCN warned that the district nurse role was in danger of extinction, yet the situation is at least as bad today. District nurses and their teams are being stretched to the point where quality is at risk – and there is no sign that the rise in demand will abate.”

The New Living Wage Represents Top Challenge to Small Businesses

New research from the Federation of Small Businesses (FSB) has found that meeting the National Living Wage (NLW) is proving a tough challenge to small businesses, 47 per cent of small business cited NLW as the main contributor to rising costs and the majority of small businesses are meeting the challenge posed by the new National Living Wage (NLW) by absorbing the costs and taking lower profits.

The FSB is now calling for the Low Pay Commission to be given flexibility on how to meet the Government’s NLW target of 60 per cent median earnings by 2020. Recommending that the target is adjusted to reflect the state of the economy and its ability to grow.

FSB research found that the majority of small business were already paying all their staff above the new NLW of £7.20 an hour. However, despite this, about a third of businesses (32%) said the new wage has led to some increase in their wage costs and further one in five (19%) said labour costs went up significantly as a result of the new wage.

Of the businesses that report increasing labour costs from the NLW, the majority of them (59%) absorbed the increased cost through reduced profitability. However, some firms have had to take other action in order to stay afloat, such as increasing their prices (35%), reducing staff hours (24%), cutting investment (23%), and recruiting fewer workers (16%). Some businesses also sought to meet the increased cost through improved efficiency (13%).

As anticipated in previous FSB research conducted before the NLW was introduced, the sectors most effected by the wage increase were those with tight margins and where low wages are most common. In particular, retail, wholesale and hospitality, and accommodation businesses say they have been negatively impacted by the NLW.

Mike Cherry, National Chairman at the Federation of Small Businesses (FSB), said:

“Small employers have stretched to meet the challenge set by the National Living Wage, with many paying their staff more by reducing operating margins. This will get harder for many firms in later years, with the targets set in a ‘pre-Brexit-decision’ economy.

“Considering the uncertain economic climate, the Low Pay Commission must be given the opportunity to adapt the target in future years so that it can be met without job losses or harming job creation. The rate of the National Living Wage should be set at a level the economy can afford, based upon economic and not political priorities.”