Expert Panel: evaluation of the Government’s commitments in the area of pharmacy in England

Health and Social Care Committee – July 2023

The Committee’s independent Expert Panel evaluating Government commitments on pharmacy has found that overall progress ‘requires improvement’ across a number of areas.

Evidence shows that demand for community pharmacy services has increased significantly with community pharmacies struggling to deliver services within the existing funding model, or even to remain open.

Community pharmacy was one of five policy areas examined by the Panel along with integrated care, hospital pharmacy, workforce education and training, and extended services. Experts found that available funding was not sufficient to keep pharmacies open, struggling financially with increased demand for dispensing, workforce pressures and rising costs due to inflation. One of the other commitments requiring improvement covered a scheme intended to protect access to local physical NHS pharmaceutical services in areas where there were fewer pharmacies.

A commitment by Government to eliminate paper prescribing in hospitals and introduce digital or e-prescribing across the entire NHS by 2024 was rated ‘inadequate’ overall. Experts found that poor ‘digital maturity’ was partly responsible and reported that even prioritised funding for IT systems was insufficient.

On workforce education and training, the report ranks a government commitment to roll out a three-year education and training programme for primary care and community pharmacy professionals as requiring improvement, with providers unable to afford to pay to backfill staff sent on courses. A commitment to make legislative changes to improve the skill mix in pharmacies and enable the clinical integration of pharmacists has not been delivered and was rated ‘inadequate’ overall.
Out of nine commitments separately evaluated over five areas, two were rated as ‘good’, five as ‘requires improvement’ and two were ‘inadequate’.

Read the Report – Expert Panel: evaluation of the Government’s commitments in the area of pharmacy in England

Rapid Literature Review: The characteristics of safety cultures

CQC – 26 July 2023

This review sets out to address what the key characteristics of good safety culture are, what are the key enablers and barriers, what evidence of good practice exists and what gaps exist in the evidence.

Read the Report – Rapid Literature Review: The characteristics of safety cultures

Delivering operational resilience across the NHS this winter

NHS England July 2023

Letter setting out our national approach to 2023/24 winter planning, and the key steps we must take together across all parts of the system to meet the challenges ahead, and a set of recommended winter roles and responsibilities to ensure clarity on what actions should be undertaken by each part of the system.

Delivering operational resilience across the NHS this winter

Cancellations of NHS care are having serious impacts on two-thirds of patients – Healthwatch report

Healthwatch – July 27th 2023

Our new research, published today, shows that people are currently facing multiple cancellations or postponements of care which are having a significant impact on their lives and symptoms, while further increasing health inequalities.  

About our research 

We commissioned a survey of 1084 people who have seen their NHS care either cancelled or postponed this year to understand the extent of disruption to care amid rising waiting lists, workforce issues, and industrial action, and other pressures on the NHS.  

Key findings 

• Over one in three, 39%, have had their NHS care cancelled or postponed two or more times this year. This has included hospital operations, tests, scans, outpatient appointments, and community health service appointments.  
• Nearly one in five (18%) of the respondents have had their care cancelled or postponed at the last minute, which the NHS defines as on the day of or on arrival to an appointment. And almost half, 45%, experienced a cancellation with between one- and seven-days notice.  
• Two-thirds of the respondents, 66%, said cancellations to care had impacted their lives, reporting ongoing pain, worsening mental health, worsening symptoms, and disrupted sleep, among many other problems.  

Read the Report – Cancelled care research

The selection and insertion of vascular grafts in haemodialysis patients – HSIB Report

HSIB – July 2023

This investigation aims to improve patient safety by supporting healthcare staff in a surgical setting to select and insert the appropriate type of implant (vascular graft) for haemodialysis treatment.

Dialysis is a procedure to remove waste products and excess fluid from the blood when a person’s kidneys stop working properly. Almost 30,000 people in the UK receive regular dialysis. The most common type of dialysis is haemodialysis, during which a patient’s blood goes through a tube into a machine to be filtered, and is then passed back into the patient’s body. To carry out haemodialysis, access is required to the bloodstream; one option for this is a vascular graft. This is a synthetic implant used to connect an artery and vein, to create a larger and stronger opening through which the blood can travel.

There are numerous types of vascular grafts produced by different manufacturers. Vascular grafts are available in different diameters and lengths, and may be either tapered or non-tapered in shape. Some vascular grafts are for delayed use, needing around 2 weeks between insertion and first use, and others are for rapid access and can be used approximately 72 hours after insertion.

This investigation used a real patient safety incident, referred to as ‘the reference event’, to examine aspects of the selection and insertion of vascular grafts, including measures to ensure the correct type is inserted. The reference event involved Teri, who had to undergo an additional procedure after the incorrect type of vascular graft was inserted for haemodialysis treatment.

The investigation’s findings, safety recommendations and safety observations aim to prevent the selection and insertion of incorrect vascular grafts from happening in the future and to improve care for patients across the NHS.

Read the Report – The selection and insertion of vascular grafts in haemodialysis patients

New review identifies poorer care and lower life expectancy for ethnic minorities with a learning disability

NHS Race and Health Observatory – July 2023

People with a learning disability from Black, South Asian (Indian, Pakistani or Bangladeshi heritage) and minority ethnic backgrounds face shorter life expectancy triggered by poorer healthcare access, experience and outcomes.

The average age of death for people with a learning disability who are from an ethnic minority is 34 years, just over half the life expectancy of white counterparts, at 62 years of age. Of those with a learning disability who die in hospital, 51% from ethnic minority groups have a ‘Do Not Attempt Cardiopulmonary Resuscitation’ (DNACPR) recommendation, compared to 73% for those who are white.

These, and other findings, will be discussed as the independent NHS Race and Health Observatory launches its new recommendations report that examines two decades of research looking into discriminatory barriers preventing equitable healthcare treatment.

Supported by NHS England, the comprehensive five-part report contains data, personal interviews and analyses undertaken by the University of Central Lancashire, in collaboration with Manchester Metropolitan University, Learning Disability England and the Race Equality Foundation.

Read the Report – ‘We deserve better: Ethnic minorities with a learning disability and access to healthcare’

2023 – Impact Report – HQIP

HQIP – July 2023

Every project within the NCAPOP has been established to address a clinical area (or areas) where healthcare improvement is required, and the common aim of each project is to have a positive impact on patient care. This compendium provides a summary of some of the key impacts the projects have had.

Impact has been categorised into four categories: national; system; local and public.

In addition, we’re focusing in greater detail on a number of projects in a collection of in-focus impact reports:

2023 – Impact Report –

2022 – Impact Report

2021-22 – In focus Impact Reports

Prevention, integration and implementation: healthcare leaders’ views on the major conditions strategy

NHS Confederation – July 2023

The major conditions strategy is a national framework being developed by the Department of Health and Social Care (DHSC) and the Office for Health Improvement and Disparities (OHID). This briefing considers how the strategy can set the conditions to prevent, treat and manage multimorbidity in England.

Read the Briefing – Prevention, integration and implementation: healthcare leaders’ views on the major conditions strategy

UKHSA strategic plan 2023 to 2026

UKHSA – 25th July 2023

This plan outlines UKHSA’s goals and strategic priorities for the next 3 years to protect the nation’s health from current and future threats.

The UK Health Security Agency (UKHSA) prepares for, prevents and responds to infectious diseases and environmental hazards to keep all our communities safe, to save lives and protect livelihoods.

The first strategic plan of UKHSA shares our vision to protect every person, community, business and public service from infectious diseases and environmental hazards, helping to create a safe and prosperous society.

Through scientific and operational leadership and in partnership with local, national and international partners our work will deliver 3 core goals:

• Prepare – be ready for, and prevent, future health security hazards
• Respond – save lives and reduce harm through effective response
• Build – develop the UK’s health security capacity

By ensuring our preparedness for, and ability to respond to, current and future health security threats, we will save lives and reduce harm, support the NHS, protect the nation’s public services and support economic growth.

The strategy sets out UKHSA’s ambitions to:

• be ready to respond to all hazards to health
• improve health outcomes through vaccines
• reduce the impact of infectious diseases and antimicrobial resistance
• protect health from threats in the environment
• improve action on public health through data and insight
• develop UKHSA as a high-performing agency

The importance of strong health protection systems that address health inequalities has never been clearer. We recognise that health threats impact people in different ways, and often disproportionately impact certain groups. We want to see reductions in health inequality over the lifetime of this strategic plan to achieve more equitable outcomes.

Read the Report – UKHSA strategic plan 2023 to 2026: securing health, saving lives and protecting livelihoods

Urgent and emergency care survey 2022

CQC – 25th July 2023

This survey looks at the experiences of people using type 1 and type 3 urgent and emergency care services.

Two questionnaires were used, tailored to each service type. Results are reported for each service type at trust and overall England level.

• Type 1 services include A&E departments, and may also be known as casualty or emergency departments.
• Type 3 services include urgent treatment centres, and may also be known as minor injury units. The survey only includes services directly run by an acute NHS trust.

The 2022 urgent and emergency care survey received feedback from 29,357 people who attended a type 1 service in September 2022 and 7,418 people who attended a Type 3 service in September 2022.

What we found

People’s experiences of urgent and emergency care are worse than in previous years. This applies more so to results for Type 1 services, where results have declined for all questions evaluating care. For some aspects of care in Type 3 services, results have remained positive, such as being listened to by health professionals.

Further information – Urgent and emergency care survey 2022