Access matters: achieving universal access to optimal lung cancer care in the UK – UK Lung Cancer Coalition

UK Lung Cancer Coalition report identifying that it is known that there is too much unwarranted variation in lung cancer care which is leading to sub-optimal outcomes for patients. This document is intended to provide some simple, practical ideas which clinicians, commissioners and policymakers could implement to help ensure that consistent and equitable treatment and care options are being offered to patients who present with similar profiles, regardless of where they live. This paper is primarily aimed at the clinical and support staff who work in lung cancer services, because this is the community of practice who can act now. However, some of the issues raised in this paper require action and support from commissioners and national policymakers.

Access matters: achieving universal access to optimal lung cancer care in the UK
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Prioritising health in our future relationship with the EU – NHS Confederation Brexit Health Alliance

NHS Confederation Brexit Health Alliance briefing following the ratification of the Withdrawal Agreement, the UK now has until the end of this year to define its future relationship with the EU. The Brexit Health Alliance is concerned that the safety and health of patients and citizens could be overlooked during the negotiations over the next eleven months and has produced a briefing and summary to highlight why time is of the essence and health must be a priority in the future relationship negotiations.

  • It will be important to define the key elements of our future relationship with the EU as early as possible, not only to end the current uncertainty, but also to make sure the UK remains an attractive place to work and live and that we are able to take advantage of global opportunities.
  • For health, the key elements include protecting citizens’ rights to reciprocal healthcare; supporting collaboration in medical research and membership of associated framework programmes; allowing alignment of standards and trade arrangements for medicines and medical devices; and protecting access to shared public health networks and alert systems.
  • The short timescales currently envisaged to agree a future trade deal with the EU present a challenge, and there is a risk that issues affecting the safety and health of patients and citizens could be overlooked during negotiations.

This briefing calls for:

  1. health to be made one of the top priorities in the UK’s negotiating mandate and for the health community to have a seat at the table, alongside business, in the development of trade policy and
    negotiations
  2. early agreements to protect patient safety, citizens’ rights to healthcare, access to medicines, and the furthering of medical research.
Prioritising health in our future relationship with the EU
Prioritising health in our future relationship with the EU
BRIEFING_Prioritising-health-in-our-future-relationship-with-the-EU-1.pdf
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PSNC Briefing 005/20: A summary of the NHS Operational Planning and Contracting Guidance 2020/21 – Pharmaceutical Services Negotiating Committee

The NHS long term plan was published in January 2019 and sets out the implementation and intended outcomes of services to be delivered by 2023/24, via a long-term revenue settlement from the government. The NHS long term plan committed to an increase in spending of £4.5 billion in real terms on primary medical and community health services by 2023/24. At the end of January 2020, NHS England and NHS Improvement (NHSE&I) published the NHS operational planning and contracting guidance 2020/21, which will help to take the NHS long term plan into its second year. This briefing summarises the elements of this guidance which are of most relevance to local pharmaceutical committee officers and members and the community pharmacy sector.

PSNC Briefing 005/20: A summary of the NHS Operational Planning and Contracting Guidance 2020/21
PSNC Briefing 005/20: A summary of the NHS Operational Planning and Contracting Guidance 2020/21
PSNC-Briefing-005.20-A-summary-of-the-NHS-Operational-Planning-and-Contracting-Guidance-2020.21.pdf
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Summary of NHS operational planning and contracting guidance 2020/21 – HfMA

The NHS operational and contractingguidance2020/211 (the guidance) is integral to the delivery of The NHS long term plan2 (summarised for members by the HFMA), setting out how the long-term revenue settlement will be invested to transform services and achieve proposed outcomes by 2023/24.

The areas of focus for 2020/21 include access to care; primary and community services; prevention; mental health; learning disability and autism; and environmental impact. The deliverablesneed to be achieved within agreed financial trajectories that deliver productivityand efficiency improvements and reduce unwarranted variation.

The guidance introduces the ‘system by default’ concept emphasising the critical role of systems. It provides guidance on workforce and financial arrangements for 2020/21, as well as the need to embrace the opportunities offered by technology. Further details will be set out in the national implementation plan and the people plan in the coming months.

Summary-of-nhs-operational-planning-and-contracting-guidance-2020-21
Summary-of-nhs-operational-planning-and-contracting-guidance-2020-21
summary-of-nhs-operational-planning-and-contracting-guidance-2020-21.pdf
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Review of capital expenditure in the NHS – National Audit Office

The NHS capital budget is for the construction of new buildings and the replacement of medical and other equipment. Capital investment is essential for modernising and improving the quality of care and for achieving the changes that will make the NHS sustainable in the longer term.  This report sets out the facts on capital investment in the NHS. It draws on and expands on issues we cover in our annual report on NHS financial sustainability.

It includes:

  • the age of the NHS estate and rising maintenance costs;
  • the allocation of the capital investment budget;
  • sources of capital funding;
  • challenges to planning and delivering an effective capital strategy.
Review of capital expenditure in the NHS: Summary
Review of capital expenditure in the NHS: Summary
Review-of-capital-expenditure-in-the-NHS.pdf
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Review of capital expenditure in the NHS: Summary
Review of capital expenditure in the NHS: Summary
Review-of-capital-expenditure-in-the-NHS-Summary.pdf
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NHS financial management and sustainability – National Audit Office

Eighth report by the National Audit Office on the financial sustainability of the NHS. To be sustainable, the NHS needs to manage patient demand (including how long patients wait) and the quality and safety of services within the resources given to it. It aims to:

  • summarise the financial and operational performance of the NHS as a whole in England in 2018-19
  • examine the financial performance of local NHS organisations
  • examine NHS service transformation and sustainability
NHS financial management and sustainability
NHS financial management and sustainability
NHS-financial-management-and-sustainability.pdf
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NHS financial management and sustainability: Summary
NHS financial management and sustainability: Summary
NHS-financial-management-and-sustainability-Summary.pdf
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Staffing for safe and effective care in the UK : 2019 report: Reviewing the progress of health and care systems against our principles – Royal College of Nursing

Royal College of Nursing progress report provides an overview of progress made against the RCN’s safe staffing campaign principles during 2019. It includes country-specific updates as well as a look ahead to priorities during 2020.  The principles:

  1. accountability: it needs to be clear whose job it is to make sure there are enough health and care staff to meet patients’ needs
  2. numbers and skill mix: the right number of health and care staff, with the right skills, to be in the right place at the right time – so patients’ needs are met, need to be in place
  3. strategy: there needs to be a vision for tackling staff shortages in health and care settings, and making sure the health and care workforce helps meet the whole country’s needs
  4. plans: clear plans for getting the right numbers and skill mix of health and care staff, and with checks to make sure they really happen
  5. education: governments must educate enough nursing students and other health and care professionals, and develop existing staff, to meet patients’ needs.
Staffing for safe and effective care in the UK : 2019 report: Reviewing the progress of health and care systems against our principles
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Miss I Aziz V Barts Health NHS Trust: 3202665/2019 – HM Courts & Tribunals Service

Employment Tribunal decision. The proceedings are dismissed following a withdrawal of the claim by the claimant.
Miss I Aziz V Barts Health NHS Trust - 3202665 2019 - Judgment
Miss I Aziz V Barts Health NHS Trust - 3202665 2019 - Judgment
Miss_I_Aziz_v_Barts_Health_NHS_Trust_-_3202665_2019_-_Judgment.pdf
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Mrs G Morris v London Ambulance Service NHS Trust: 3201533/2019 – HM Courts & Tribunals Service

Employment Tribunal decision. The unanimous judgment of the Tribunal is that:-
  1. The Claimant was not treated less favourably contrary to Regulation 5 of the Part-time Workers (Prevention of Less Favourable Treatment) Regulations 2000.
  2. Her claim is therefore dismissed.
Mrs G Morris v London Ambulance Service NHS Trust: 3201533/2019
Mrs G Morris v London Ambulance Service NHS Trust: 3201533/2019
Mrs_G_Morris_v_London_Ambulance_Service_NHS_Trust_-_3201533_2019_-_Reserved_Judgment.pdf
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Ms N Spence v Barts Health NHS Trust: 3201645/2019 – HM Courts & Tribunals Service

Employment Tribunal decision. The proceedings are dismissed following a withdrawal of the claim by the claimant.
Ms N Spence V Barts Hralth NHS Trust - 3201645 2019 - Judgment
Ms N Spence V Barts Hralth NHS Trust - 3201645 2019 - Judgment
Ms_N_Spence_v_barts_Hralth_NHS_Trust_-_3201645_2019_-_Judgment.pdf
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Sustainability in Public Health England 2019 – Public Health England

This report outlines the sustainable development activities in Public Health England. It contains an analysis of the organisation’s carbon footprint – particularly in relation to:

  • the use of energy and water;
  • the production and management of waste;
  • business travel undertaken.

It also highlights work on other aspects of sustainability, such as health and wellbeing and the health effects of climate change.

Sustainability in Public Health England 2019
Sustainability in Public Health England 2019
Annual_Sustainability_Report_2019__1_.pdf
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The state of the nation: Sexually transmitted infections in England – Terrence Higgins Trust and British Association for Sexual Health and HIV

Terrence Higgins Trust and and British Association for Sexual Health and HIV report, calls for the Government to implement a new sexual health strategy, including the need for immediate steps to be taken on the threat of drug resistant STIs. The report shows that someone is diagnosed with an STI every 70 seconds.  It calls on the Government to make improving sexual health a priority following nearly half a million (447,694) cases of STIs diagnosed in England in 2018 alone.  2018 figures increase expressed as a percentage by STI are given as:

  • Gonorrhoea increased by 249%
  • Syphilis increased by 165%
  • Chlamydia increased by 6%

This is set against a backdrop of government funding reduction for sexual health services by a quarter since 2014.

The state of the nation: Sexually transmitted infections in England
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Sherwood Forest Hospitals NHS Foundation Trust & Anor v H (Rev 1) [2020] EWCOP 6 (03 February 2020) – England and Wales Court of Protection

From England and Wales Court of Protection Decisions. The judge has given leave for this version of the judgment to be published on condition that (irrespective of what is contained in the judgment) in any published version of the judgment the anonymity of the respondent and members of their family must be strictly preserved. All persons, including representatives of the media, must ensure that this condition is strictly complied with. Failure to do so will be a contempt of court. Judgment concerns Mrs H, who is suffering from squamous cell carcinoma (‘SCC’), which had manifested itself on her left cheek and which had grown significantly in the period between early December 2019 and mid-January 2020.

Calls on the Trusts to put together a care plan which will best meet Mrs H’s needs for the remainder of her life, however long or short that may be. When they have done so, this court will review it and evaluate whether it meets Mrs H’s best interests (see Aintree University Hospitals NHS Foundation Trust v. James [2013] UKSC 67; Re D [2012] EWCOP 885; Salford Royal Foundation Trust v. Mrs P [2017] EWCOP 23). The judge has listed the case for review of the care plan for two reasons: firstly, because in their view the history of this case requires that it is monitored; and secondly, because T has requested that they overview the plan.

Sherwood Forest Hospitals NHS Foundation Trust & Anor v H (Rev 1) [2020] EWCOP 6 (03 February 2020)
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Mr Ahmed Tayel v Ipswich Hospital NHS Trust and others: 3305873/2018 – HM Courts & Tribunals Service

Employment Tribunal decision.
Reserved Judgement:
  1. The allegations of harassment and victimisation contained at paragraphs 14 and 15 of the Particulars of Claim dated 11 April 2018 are dismissed on withdrawal by the claimant.

Public Health England (‘PHE’)

  1. The claims against Public Health England are struck out as an abuse of process the claims already having been brought in case number 3325693/2017 and struck out.
  2. Further and/or in the alternative the claims have been submitted out of time, the tribunal has no jurisdiction and the claims are struck out
  3. Further and/or in the alternative the claimant is not an employee or applicant under the Equality Act 2010 to bring a claim against Public Health England in relation to his request for information of the 5 May  Case Number: 3305873/2018 and subsequently on the 25 February and 9 March 2018 and that claim is struck out.
  4. This tribunal has no jurisdiction in relation to a Subject Access Request and that claim is struck out.

Certificate of Correction

Under the provisions of Rule 69 the Reserved Judgment sent to the parties on the 13 December 2019 is corrected to show that:

  1. Ipswich Hospital NHS Trust and Colchester University NHS Foundation Trust have merged into one organisation called East Suffolk and North Essex NHS Foundation Trust, and
  2. The award in case number 3305873/2018 was against Ipswich Hospital now East Suffolk and North Essex NHS Foundation Trust.

Reconsideration Judgement

The claimant’s applications dated 18 March 2019 for reconsideration of the judgment sent to the parties on 4 March 2019 is refused.

Mr A Tayel V Ipswich Hospital NHS Trust Others 3305873-18 - RESERVED JUDGMENT And REASONS
Mr A Tayel V Ipswich Hospital NHS Trust Others 3305873-18 - RESERVED JUDGMENT And REASONS
Mr_A_Tayel_v_Ipswich_Hospital_NHS_Trust___Others_3305873-18_-_RESERVED_JUDGMENT_and_REASONS_.pdf
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Mr A Tayel - V - Ipswich Hospital NHS Trust Others - 3325693-2017 - Certificate Of Correction
Mr A Tayel - V - Ipswich Hospital NHS Trust Others - 3325693-2017 - Certificate Of Correction
Mr_A_Tayel_-_v_-_Ipswich_Hospital_NHS_Trust___Others_-_3325693-2017_-_Certificate_of_Correction.pdf
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Mr A Tayel V Ipswich Hospital Others-3305873-2018-Judgment
Mr A Tayel V Ipswich Hospital Others-3305873-2018-Judgment
Mr_A_Tayel_v_Ipswich_Hospital___others-3305873-2018-Judgment.pdf
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Thinking differently about commissioning: Learning from new approaches to local planning – The King’s Fund

In recent years national policy has been emphasising the importance of collaboration within local health and care systems. Since the NHS five year forward view in 2014, several initiatives, including the new care models programme and integrated care systems (ICSs), have promoted collaborative approaches in which providers from different parts of the NHS or providers and commissioners work together to plan and develop services. The NHS long term plan has indicated that ICSs will cover England by 2021.

These developments have major implications for how commissioning operates in practice.  This King’s Fund report aims to:

  • understand the approach being taken by some clinical commissioning groups (CCGs) and local systems that are re-thinking the role of commissioning
  • draw out learning for other areas as they work to change their approach
  • explore the national policy implications of this new way of working and what national bodies can do to support its development.

Regulation 28: Report to prevent future deaths: Agnes Sansom – Courts and Tribunal Judiciary

Date of report: 7 January 2020

Ref: 2020-0002

Deceased name: Agnes Sansom

Coroners name: Jeremy Chipperfield

Coroners Area: County Durham and Darlington

Category: Hospital Death (Clinical Procedures and medical management) related deaths

This report is being sent to: County Durham and Darlington NHS Trust

Matters of Concern:

The deceased was admitted to University Hospital of North Durham on 15th July 2019. She was known to be at risk of falling and of suffering serious injury or death in the event of falling.

The deceased was obliged to share a zimmer frame with another patient on the ward.

  1. existing patient record systems fail to ensure that important and urgent information is brought, in a timely way, to the attention of those who need it; and
  2. vulnerable patients are obliged to share walking aids on hospital wards.
Regulation 28: Report to prevent future deaths: Agnes Sansom
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Regulation 28: Report to prevent future deaths: Annette Lewis – Courts and Tribunal Judiciary

Date of report: 13 Jannuary 2020

Ref: 2020-0004

Deceased name: Annette Lewis

Coroners name: Caroline Sumeray

Coroners Area: Isle of Wight

Category: Hospital Death (Clinical Procedures and medical management) related deaths

This report is being sent to: National Trust for the Isle of Wight; Public Health for the Isle of Wight

Matters of Concern:

  1. Evidence was given that there are no fences to protect the public from falling over the edge of the cliff at Tennyson Down, and moreover that there are no signs providing those in some sort of mental distress with the number for the Samaritans. Whilst I acknowledge that putting fences around the edge of the cliff would be a massive undertaking by the landowners, it may prevent a future death if those who are in extremis are reminded that there are people out there who are trained to assist them at that time.
  2. Having just concluded a similar inquest involving a woman who threw herself from the top of Culver Cliff where I raised similar concerns with both the National Trust and the Director of Public Health who heads up the Suicide Prevention Group on the Isle of Wight, it seems appropriate that if consideration is being given by these organisations to better signage being implemented at the top of Culver Cliff, at the same time, consideration can also be given to making similar improvements at Tennyson Down.
Regulation 28: Report to prevent future deaths: Annette Lewis
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Regulation 28: Report to prevent future deaths: Peter Sudlow – Courts and Tribunal Judiciary

Date of report: 17 January 2020

Ref: 2020-0012

Deceased name: Peter Sudlow

Coroners name: Joanne Lees

Coroners Area: Shropshire, Telford & Wrekin

Category: Hospital Death (Clinical Procedures and medical management) related deaths

This report is being sent to: Shrewburys and Telford Hospital NHS Trust

Matters of concern:

The deceased died from a naturally incurring infection of a pressure sore which originated during a hospital stay following a prolonged period of immobility on a background of ischaemic myelopathy and profound persisting paraplegia.

  1. During the period of time the deceased spent in hospital between 23/1/19 and 23/2/19 there was no referral to the Tissue Viability Nurse (TVN) at any time.
  2. There was no referral to the TVN when the sore was categorised as a grade 2.
  3. There was no referral to the TVN when the Waterlow score of the deceased increased to 17.
  4. There was no referral to the TVN when the deceased was readmitted to hospital on 16/3/19 and the pressure sore determined to be Grade 4 until 22/3/19.
  5. There was no clear guidance as to when and in what circumstances a referral to the TVN should be made.
  6. The deceased presented with additional risks as determined by the Waterlow score with paraplegia and there was no clear guidance as to when a TVN referral should be made for those patients with additional risks such as paraplegia or neurological deficit for the purpose of seeking advice as to the prevention of pressure sores.
  7. There was no clear guidance as to the involvement of the TVN in developing a plan to prevent pressure sores in those patients presenting with additional risks such as paraplegia or a neurological deficit.
  8. There was no clear guidance as to the relationship between the determination of the Waterlow score and referral to the TVN to assist nursing staff.
  9. The new Pressure Ulcer Prevention and Treatment 2 week booklet (PUPT) makes no reference to a TVN referral until a pressure ulcer has reached Category or Grade 3.
Regulation 28: Report to prevent future deaths: Peter Sudlow
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Regulation 28: Report to prevent future deaths: Gordon Gillott – Courts and Tribunal Judiciary

Date of report: 4 February 2020

Ref: 2020-0020

Deceased name: Gordon Gillott

Coroners name: Emma Serrano

Coroners Area: Derby and Derbyshire

Category: Emergency services related deaths (2019 onwards); Hospital Death (Clinical Procedures and medical management) related deaths

This report is being sent to: East Midlands Ambulance Service; Chesterfield Royal Hospital; Royal Derby Hospital

Matters of concern:

Mr Gillott’s Transfer to the Royal Derby Hospital was delayed substantially.  Whilst this delay did not affect Mr Gillott, were this to happen again in the future, there is a risk of future death if urgent transfers are not available to acutely illpatients due to resourcing issues.

Regulation 28: Report to prevent future deaths: Gordon Gillott
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Regulation 28: Report to prevent future deaths: Maureen Brown – Courts and Tribunal Judiciary

Date of report: 4 February 2020

Ref: 2020-0021

Deceased name: Maureen Brown

Coroners name: Emma Serrano

Coroners Area: Derby and Derbyshire

Category: Hospital Death (Clinical Procedures and medical management) related deaths

This report is being sent to: University Hospital of Derby and Burton; NHS England

Matters of concern:

  1. Evidence emerged during the inquest that the electronic transfer information is the only information that the receiving ward is given before a patient is transferred. Other relevant information, that is necessary for an effective handover to take place, can be missed as the electronic transfer system limits how much information can be recorded.
  2. Evidence was heard regarding the steps that the Royal Derby Hospital has made to remedy this issue. However, the national policy still states that the only piece of information necessary for a transfer is the electronic transfer  information.
Regulation 28: Report to prevent future deaths: Maureen Brown
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