Tackling the cost of living crisis and impacts on health and wellbeing: Key actions health and care policy makers, commissioners and provider organisations can take

VCSE Health and Wellbeing – March 2023

This resource, launched by members of the VCSE Health and Wellbeing Alliance, discusses how the ongoing cost of living crisis is having a significant impact on health and wellbeing, with particularly acute challenges being faced by those who already experience health inequalities. It identifies six key actions health and care policy-makers, commissioners and provider organisations can take to mitigate the impact of the cost-of-living crisis on people’s health and wellbeing.

Further information – Tackling the cost of living crisis and impacts on health and wellbeing: Key actions health and care policy makers, commissioners and provider organisations can take

Dementia and all-cause mortality and deaths involving coronavirus (COVID-19), England: 24 January 2020 to 31 December 2022

Office for National Statistics – 14th April 2023

The risk of death among people aged 65 years and over with and without dementia.

Dementia and all-cause mortality and deaths involving coronavirus (COVID-19), England: 24 January 2020 to 31 December 2022

National Lung Cancer Audit (NLCA) – State of the nation report 2023

HQIP –  Published: 12 Apr 2023

The National Lung Cancer Audit (NLCA) has published a State of the Nation Report 2023. Based on patients diagnosed with lung cancer in England during 2021, and in Wales in 2020-2021, it summarises the performance of lung cancer services on a set of performance indicators and patient outcomes.

The report found that the number of patients diagnosed in England in 2021 has recovered to pre- pandemic levels, with 34,478 patients diagnosed with lung cancer (compared to 31,371 in 2020 and 33,091 in 2019). It also found that the Covid-19 pandemic had an impact on the number of patients diagnosed in Wales, which fell from 2,240 in 2019 to 2,067 in 2020 (with a subsequent recovery in 2021 to 2,244).

Other key findings for England include:The proportion of patients with stage I/II PS 0–2 non-small cell lung cancer (NSCLC) undergoing curative-intent treatment in England has increased from 73% in 2020 to 79% in 2021, andThe proportion of patients with NSCLC stage IIIB-IV and PS 0-1 receiving systemic anti-cancer therapy in England has increased from 55% in 2020 to 61% in 2021.

For Wales, there was a reduction in the number of patients with NSCLC undergoing surgery or treatment with curative-intent, compared with 2019 – and, by 2021, the number of patients undergoing these treatments had not recovered to 2019 pre- pandemic levels.

Read the Report – National Lung Cancer Audit (NLCA) – State of the nation report 2023

Is Hewitt turning the tide of performance management or swimming against it?

The King’s Fund – 05 April 2023

Patricia Hewitt’s independent review of integrated care systems (ICSs) is aimed squarely at one of the biggest challenges facing ICSs – the strong culture of top-down performance management in the NHS. The reforms introduced by the 2022 Health and Care Act, with their focus on collaboration across boundaries in local systems, represent a direct challenge to this hierarchical culture, and without a new approach to accountability in the NHS there is little hope of ICSs living up to their original promise. 

Is Hewitt turning the tide of performance management or swimming against it?

NHS Key Statistics: England, March 2023

House of Commons Library – March 2023

Summary of NHS demand, performance, backlogs, and capacity of services in England. It covers A&E statistics, waiting lists, cancer waiting times, ambulance response times, delayed discharges, staffing levels including doctors and nurses, and more.

NHS Key Statistics March 2023 – full report (673 KB , PDF)

Primary care commissioning assurance framework

NHS England – 12th April 2023

The assurance framework sets out how NHS England will be assured that integrated care boards (ICBs) are exercising the delegated functions safely, effectively, and in line with legal requirements. The aim of the framework is to provide ICBs with details of what NHS England will need to be assured of and how they can evidence this to demonstrate compliance.

Primary care commissioning assurance framework

Parliamentary and Health Service Ombudsman scrutiny 2021–22

Public Administration and Constitutional Affairs Committee – 28 March 2023

This report of the annual scrutiny inquiry into the work of the Parliamentary and Health Service Ombudsman (PHSO) raised concerns with the PHSO continuing its policy of not considering less serious health complaints, introduced to reduce the backlog of cases resulting from the Covid-19 pandemic. The Committee also noted that it received written evidence that expressed dissatisfaction with the PHSO’s handling of complaints, and that the organisation failed to meet its targets for time taken to close cases, as reported in its annual report and accounts.

Read the Report – Parliamentary and Health Service Ombudsman scrutiny 2021–22

Fracture Liaison Service Database

Updated on NCAB 05 April 2023 from the FLDB 2022 report published 13/01/2022 covering data January to December 2020.

Fracture Liaison Service Database

NEW Benchmarking data available: National Audit of Inpatient Falls

HQIP – 4th April 2023

Data from the National Audit of Inpatient Falls (NAIF) is the latest dataset to be published on the National Clinical Audit Benchmarking (NCAB) website.

It was updated on the 17 March 2023 from the NAIF 2021 report published in November 2021 covering data January to December 2020.

NCAB is an online portal, hosted by HQIP, which provides access to national audit performance data. Users do not need to register, and can access audit benchmarked data searchable by speciality, Trust, hospital or unit.

National Audit of Inpatient Falls

Adult social care system reform: next steps to put People at the Heart of Care

Dept of Health and Social Care – 4th April 2023

The People at the Heart of Care white paper, published in December 2021, set out a 10-year vision for adult social care. It was shaped by national and local government, care providers, care staff, the NHS, people who draw on care and support, their friends and family, charities and the voluntary sector. The vision puts people at its heart and revolves around 3 objectives:

1. People have choice, control and support to live independent lives.
2. People can access outstanding quality and tailored care and support.
3. People find adult social care fair and accessible.

This plan sets out how we are building on our progress over the last year by implementing the most impactful proposals, along with some new commitments. It includes key milestones for reform and sets out the change we will see for people who draw on care and support, unpaid carers, and people who work in social care. Some of the key activities include:

• improving access to care and support: we are helping local authorities to increase their adult social care capacity and make tangible improvements to services by investing £562 million in 2023 to 2024 and £845 million in 2024 to 2025 through the Market Sustainability and Improvement Fund. We are also launching a programme in summer 2023 to help local areas establish support arrangements for international recruitment in adult social care to bolster the workforce. We will expand the NHS Volunteer Responders programme from this year to create a joint health and social care volunteer programme. Improved capacity and better support for international recruits and volunteers will enable more people to access the right care, in the right place, at the right time
• recognising skills for careers in care: we are improving recognition of the skills and experience of people working in care and supporting career development through our plan for the care workforce. This includes the introduction of a new care workforce pathway for adult social care, a new Care Certificate qualification, a skills passport to provide a verifiable record of training and qualifications and a range of new, funded training schemes. We know that the capability and compassion of care workers makes all the difference to the lives of the people they care for and we want to better recognise these skills
• digital transformation in adult social care: we are supporting the testing and scaling of new technologies through 2023 to 2025 to improve care quality and safety; and increasing uptake of digital social care records by 2025, which enables your care information to be shared securely and in real-time with authorised professionals in the NHS and social care. We are also developing a scaled-up future digital learning offer, so that digital skills are embedded in core training and development opportunities for staff
• personalising care through stronger data: we are introducing person-level data collection from April 2023. Better insights into care journeys and outcomes will help to show which interventions work best and we can improve how people move between health and social care. By the end of 2023 we will finalise our roadmap for improving how data is collected, used and shared. In February we published a draft of Care data matters so that we can involve people who draw on, work in or provide, or are supported by adult social care in the development of this roadmap
• improving transparency and accountability: we are introducing CQC assessment of local authorities’ adult social care delivery from April 2023 to better understand the quality of care in local areas. This will enhance transparency, improve local accountability and help to identify good practice so that more people can benefit from high quality care and support
• supporting people to remain independent at home: we are launching a new, independently chaired Older People’s Housing Taskforce that will make recommendations to ministers on how we can unlock investment in retirement housing to provide more choice of suitable housing for people in later life. We will also provide additional funding for people to make adaptations and repairs to their homes so that they can stay independent for longer and return home from hospital more quickly
• driving innovation and improvement: we are launching a 2-year targeted fund in 2023 to test and scale ways to innovate and transform local authority processes. This will provide targeted support for local authorities and establish a new innovation and improvement unit within DHSC. We will work with sector partners to shape the strategic direction for improvement and innovation, helping tackle operational challenges and overcome the barriers to adopting and scaling new approaches
• joining up services to support people and carers: we are supporting our recently established integrated care systems (ICSs), and the organisations within them, to better join up care through the expansion of our Better Care Fund (BCF) Support Programme and the launch of a new national leadership programme for local health and social care leaders. We are also investing in additional support for unpaid carers in recognition of the enormous contribution they make, which is reflected throughout this plan

This is just some of the activity included in our comprehensive package. This plan is a crucial step towards our 10-year vision. We will continue to engage with all those people and organisations at the heart of providing and drawing on care as we implement our reforms and make further progress towards our vision.

Read the paper – Adult social care system reform: next steps to put People at the Heart of Care