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** 29 May 2024
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** UK
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** ICSs ordered to revisit ‘unaffordable’ £3bn deficit plans (#1)
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** Half of players using snus would like to stop – study (#2)
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** Bristol obesity plan with system-wide approach to oppose companies ‘selling really s*** food’ (#3)
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** UK
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** ICSs ordered to revisit ‘unaffordable’ £3bn deficit plans
A £3bn gap in systems’ latest financial plans is likely to lead to cutting planned investment and further raids on capital, HSJ has learned.
Local sources said NHS England had rejected many of the spending plans submitted by trusts and commissioners at the start of this month, and is now demanding further savings.
At just under £3bn, the scale of the projected deficit is around four times higher than at the equivalent point last year. NHS England is understood to regard the current gap as “unaffordable” nationally, as local deficits on this scale would require deep cuts to central budgets.
Addressing it is now likely to lead to curtailing plans to increase activity for cutting waiting lists, and transferring capital budgets.
One ICS chair said the forecast gap was proving more stubborn than in previous years.
A system finance boss elsewhere said they were trying to bridge the gap by accelerating existing savings plans, including reducing non-clinical staff. However they added: “These are all very doable but the problem is doing them all in this year. The levels of efficiency in plans will now be huge.”
Sarah Walter, director of the NHS Confederation ICS network, said the practice of repeatedly topping up budgets during the financial year “creates unnecessary uncertainty and bureaucracy for NHS leaders and feeds into the short-term approach that inhibits effective planning”.
She said: “If ICSs are to balance budgets, they will need greater autonomy and freedom to make difficult decisions about things like service reconfigurations, as well as a political context where leaders are honest about what can be achieved with the resources available.”
Source: HSJ, 29 May 2024
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** Half of players using snus would like to stop – study
Almost one in five male professional players who took part in a new survey are using snus, nicotine pouches or both - and nearly half would like to stop using snus within 12 months.
The study by Loughborough University, commissioned by the Professional Footballers' Association (PFA), also identified that two out of five players had tried the pouches at least once.
The report suggests the actual usage figures are "likely" to be higher because players may not want to disclose they use snus even in an anonymous survey, which was the first research on its specific use in football.
As many as 628 male players, based at either Premier League or EFL clubs, were surveyed - as well as 51 Women's Super League players.
Of the male respondents, 18% said they currently use snus while 42% said they had tried the substance at least once. The figures for female players were 22% and 39% respectively.
Nearly half of the men (48%) indicated a desire to quit using snus in the next year, but just 9% in the WSL.
Snus is a tobacco product in a sachet, similar to a small tea bag, which is placed under the lip and releases nicotine into the bloodstream. It is illegal to be sold in the United Kingdom but not against the law to use, while tobacco-free nicotine pouches are legal.
Most players used nicotine pouches rather than tobacco-based snus. However, they often referred to nicotine pouches using the term 'snus'.
The report noted that a review of available evidence suggests snus use is associated with an increased risk of oesophagus and pancreatic cancer in comparison to non-smokers, and to an increased risk of cardiovascular disease.
There is also strong evidence of an association between snus use and mouth lesions.
A majority of male players (58%) and more than three-quarters of female players (86%) in the study said they had not previously received any education about snus.
"This is an important piece of work that will help players, clubs and medical staff make informed decisions about snus use," said Dr Michael Bennett, the PFA's director of player wellbeing.
"Importantly, these findings tell us that while a lot of players appear to be looking to substances like snus as a coping mechanism to handle the growing demands of the game, many are not fully aware of its effects and addictive qualities."
Source: BBC, 28 May 2024
See also: Loughborough University – Snus use in English Professional Football ([link removed])
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** Bristol obesity plan with system-wide approach to oppose companies ‘selling really s*** food’
A new action plan to halt rising obesity levels in Bristol could take a “system-wide approach” and oppose companies “selling really s*** food”.
Public health experts believe systemic changes are needed in the wider Bristol region to help people reach and maintain a healthy weight.
Changes could be coming to school dinners and meals served in hospitals, after concerns about the quality and healthiness of this food. One council boss said companies were “perpetuating really poor diets”, and called for similar measures to anti-smoking policies.
Action will be coordinated across local councils and NHS organisations that form the Bristol, North Somerset and South Gloucestershire Integrated Care System. The plan was discussed during a meeting of the health and wellbeing board on Thursday, May 23 at Bristol City Council.
Emily Moseley, a public health registrar, said: “One in five children are living with overweight or obesity when they start school, and this increases to one in three by the time they leave school. This has a big impact on the NHS, as obesity is linked to a range of non-communicable diseases.
“It’s possible that obesity could overtake tobacco and smoking as the biggest cause of preventable death. This impact isn’t felt equally across society, with lower income households facing multiple challenges in managing finances, making it harder to access nutritious food and opportunities to be physically active.”
She added there was a clear link between poverty and obesity, with more overweight people living in the poorer parts of Bristol. According to the council’s quality of life survey, the area with the highest level of people who are overweight and obese is Stockwood, followed by Brislington East, Henbury and Brentry.
She said: “Obesity is still regarded by many as a lifestyle choice, irrespective of the wider environmental context. There are a wide range of factors influencing an individual’s weight. Obesity isn’t based on willpower or personal responsibility. Our health-related behaviour and habits are influenced by our income, childhood and where we grow up.
“Obesity is a societal rather than an individual responsibility. The solution to that is creating environments within communities that embed nutrition and regular physical activity, making the healthy choice the easy choice. Small changes on a system level can have a really big impact on the health of the population as a whole.”
Source: Bristol Live, 28 May 2024
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