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Don’t recreate SHAs’, government told ahead of NHS bill
NHS Providers will this week warn against ‘re-establishing an all-powerful quasi-strategic health authority tier’, as government prepares to legislate for integrated care systems (ICSs). The Government is expected to bring forward an NHS bill next year, which is likely to give a legal basis to ICSs, among other changes.
This could vary from setting them up as loose committees – not very different from the current arrangement – through to making them statutory bodies with strong powers over NHS providers, similar to the SHAs which were abolished in 2013. Some believe the latter is necessary to properly coordinate and reconfigure services which are run by independent foundation trusts, and officials have considered giving ICSs or regulators the power to direct foundation trusts in recent years.
But NHS Providers (NHSP) – which represents trusts – told HSJ it would argue that this option would damage trust boards’ accountability, and move responsibility away from the frontline.
NHSP chief executive Chris Hopson will say at the organisation’s conference this week: “The argument is that that unitary trust board, underpinned by law, is the right governance mechanism, at the right level, on the right size of footprint and population size, to oversee the delivery of frontline secondary care. We cut across, or cloud, that clarity of governance, accountability and assurance at our peril. For example, by re-establishing an all-powerful quasi strategic health authority tier, as some have argued.”
He will say the service “must now rapidly move to greater system working, no ifs, no buts”, but that if ICSs are given “formal accountabilities [they] have to be clearly defined, underpinned in law and have no overlap with the accountabilities exercised by organisations within the system footprint such as trusts and [clinical commissioning groups]”.
He will also warn against making ICSs more like large NHS commissioning bodies, as this could “exclude, marginalise or just plain bore key [non NHS] partners” like local authorities.
Source: Health Service Journal, 5 October 2020
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If you’re lonely you may find it difficult to stop smoking
New research from the University of Bristol has found that feeling lonely makes quitting smoking particularly difficult. According to the Office for National Statistics, the equivalent of 7.4 million people said their wellbeing was affected through feeling lonely in the first month of lockdown.
Dr Robyn Wootton, senior research associate at Bristol University, said: “We found evidence to suggest that loneliness leads to increased smoking, with people more likely to start smoking, to smoke more cigarettes and to be less likely to quit.”
Senior author Dr Jorien Treur from Amsterdam UMC added: “Our finding that smoking may also lead to more loneliness is tentative, but it is in line with other recent studies that identified smoking as a risk factor for poor mental health. A potential mechanism for this relationship is that nicotine from cigarette smoke interferes with neurotransmitters such as dopamine in the brain.”
Deborah Arnott, chief executive of public health charity ASH, said: “If lonely people are more likely to start smoking and find it harder to quit, they are more likely to suffer the harm caused by smoking. This research highlights the need for smokers suffering from loneliness to be given support to stop, to improve not just their health and wellbeing but also to help them in their loneliness.”
Source: The Mirror, 5 October 2020
Wootton RE et al. Bidirectional effects between loneliness, smoking and alcohol use: evidence from a Mendelian randomization study. Addiction. 2020 Jun 29.
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Northern Ireland: New figures show rise in home fires caused by cigarettes since lockdown
Accidental house fires sparked by cigarettes have jumped 87% since lockdown, it has been revealed. Data released today by the Northern Ireland Fire and Rescue Service show that call outs increased during the pandemic, from 327 in 2019, to 376. The number caused by cigarettes, cigars or pipes has almost doubled.
Group Commander Gerry Lennon said "smoking materials" were linked to every fatal house fire in 2019. He added: "An 87% increase is quite a stark figure - bear in mind that smoking is responsible for the most fire deaths, as opposed to cooking which is the main cause of fires.”
“Since Covid things have changed, I think more people are maybe smoking in the home, due to the fact they’re spending more time in the home, and they were forgetting the basic safety advice."
Source: Belfast Live, 5 October 2020
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Comment: Dido Harding is the problem with NHS Test and Trace – but not for the reason you think
Writing in the New Statesman, Stephen Bush discusses the assumptions underpinning the Government’s decision to replace Public Health England (PHE) with the National Institute for Health Protection (NIHP) and embark on a reorganisation of England’s public health system mid-pandemic.
Bush states that the reorganisation of PHE rests on three key assumptions: (1) that PHE was the major problem with the initial COVID-19 response; (2) that the new body is the solution; (3) that getting from the old body to the new mid-pandemic is achievable and worthwhile.
The risk, according to Bush, is that if any one of these assumptions is incorrect then the reorganisation could end up damaging, rather than improving, the country’s public health system.
He argues that rather than conduct a quick, independent inquiry to identify whether or not PHE was the problem in the initial COVID-19 response, the Government has opted to reorganise its public health body mid-pandemic: “Building the plane as you fly it is so high risk that unless it is absolutely unavoidable, you probably shouldn’t do it.”
He concludes that the appointment of Dido Harding to head the new NIHP, is symptomatic of a Government that “believes the only purpose of an independent inquiry would be to cause it political difficulties, rather than something that would improve and sharpen its pandemic response.”
Source: The New Statesman, 5 October 2020
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ASH Daily News is a digest of published news on smoking-related topics. ASH is not responsible for the content of external websites. ASH does not necessarily endorse the material contained in this bulletin.
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