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Matt Hancock told MPs yesterday, 11th February, that there was “no better time than now” to reorganise the NHS in England as he announced the anticipated white paper bringing changes to the management and structure of the NHS. “The pandemic has made the changes in this white paper more, not less, urgent,” he added.
It is a partial reversal of 2012 reforms and Hancock said that the changes would make it easier for health bodies to work together in the interests of patients by getting rid of bureaucratic rules requiring competition.
The NHS internal market has been retained however, with last-minute additions to the white paper specifying that the divide between buyers and sellers of care would not be scrapped. Hancock is using the new laws to impose greater ministerial control over the health service, which was handed day-to-day independence under the 2012 law. He will gain powers to issue direct orders to NHS England, adjust his strategic instructions more often and intervene directly to block changes to local hospitals.
Jeremy Hunt, Hancock’s predecessor who now chairs the health select committee, backed the “brave” decision to change structures.
Jonathan Ashworth, the shadow health secretary, welcomed the goal of integrated care but said: “The test of the reorganisation will be whether it brings down waiting lists and times.” He contrasted the success of the vaccination programme, run by the NHS, with that of Test and Trace, run by ministers, to warn against centralising power.
Source: The Times, 11 February 2021
See also: DHSC - Integration and Innovation: working together to improve health and social care for all
The BMJ - NHS reorganisation must not be rushed through during pandemic, leaders warn
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NHS commissioners seeking to procure services would need to consider the “social value” of their decisions, under new proposals. The requirement would be part of a proposed new procurement regime drawn up by NHS England, which outlines the options open to commissioners when selecting or continuing to work with providers.
A consultation document published by NHS England proposes what the new regime should look like, outlining the steps in scope in three scenarios. In the first scenario, where the commissioner wants to continue with the incumbent provider, the document saying this should be “straightforward” to achieve where there is no viable alternative, or if the existing provider is “doing a good job and the service is not changing.”
A second scenario would arise where a new service is being established, services need to change substantially, or either party wants to cease an existing contract. In this case, the commissioner would need to consider a set of “key criteria” after which it could award the contract to a provider it found most suitable, without a tender process.
In a third scenario, where the commissioner cannot identify a provider most suitable without running a competitive process or wants to use a competitive process, it can proceed to tender the contract, the paper says.
The paper says patients will retain the legal right, which they currently have in some cases, to choose where they are treated under the “any qualified provider” framework. Meanwhile, the document also proposes that the UK’s future trade deals with other countries should “support and reinforce” the new regime. It adds: “We…propose to work with [the] government to ensure that the arranging (procuring and sub-contracting) of healthcare services by public bodies for the purposes of the health service in England is not to be included within the scope of any future trade agreements.”
Source: The HSJ, 11 February 2021
See also: NHS Provider Selection Regime Consultation on proposals
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More deaths in England and Scotland may be due to obesity, study warns
New research suggests that since 2014, obesity and excess body fat have contributed to more deaths than smoking in both England and Scotland.
The researchers analysed data on 192,239 adults with an average age of 50 collected between 2003 and 2017 as part of health surveys for England and Scotland. The participants reported their smoking habits, and trained interviewers or nurses measured their height and weight. The researchers combined their data with estimates of the risk of dying from smoking (17 studies) or obesity and excess body fat (198 studies).
The team found that deaths attributable to smoking between 2003 and 2017 decreased from 23.1% to 19.4%, whereas deaths attributed to obesity and excess body fat rose from 17.9% to 23.1%. The authors also found that while obesity was likely to cause more deaths in older adults, smoking was still more likely to contribute to younger adults’ deaths. The data showed that in the 16-44 age group, smoking was 2.4% more likely to have contributed to deaths than obesity.
Experts think this could be due to a drive-in anti-smoking messaging and health campaigns leading to more people quitting. Jill Pell, the lead author from the University of Glasgow, said: “The increase in estimated deaths due to obesity and excess body fat is likely to be due to their contributions to cancer and cardiovascular disease. Our findings suggest that the public health and policy interventions aimed at reducing the prevalence of smoking have been successful and that national strategies to address obesity and excess body fat, particularly focusing on middle-aged and older age groups and men, should be a public health priority.”
The authors caution that the number of deaths attributed to smoking, obesity and excess body fat in this study are estimates only. Factors influencing these deaths require further investigation.
Source: Medical Xpress, 11 February 2021
BMJ - Changes over 15 years in the contribution of adiposity and smoking to deaths in England and Scotland
Editorial Note:
This study has found significantly different burdens of disease from those found by the Global Burden of Disease Study which recently assessed that the burden of disease from tobacco in the UK was 21% and 9% was caused by obesity. These different findings are likely to be due to the different methods and datasets used in each study.
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The African Centre for Corrective and Preventive Action is calling for the Minimum Legal Access age for tobacco in Kenya to be raised from 18 to 21 years old.
The NGO delivered a petition to the Kenyan Senate and the National Assembly calling for the increase. In a statement, the NGO Executive Chairman Mwangi Macharia said that increasing the minimum legal age for tobacco sales and access would help prevent smoking initiation among young people, leading to lower smoking prevalence rates and saving millions of dollars in health care costs. The African Centre for Corrective and Preventive Action also called on legislators to simplify identity checks for retailers to facilitate compliance with the proposed increase.
Source: KBC Channel, 11 Feb 2021
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Getting back on track Delivering a smokefree start for every child
On Wednesday, 10 February 2021, ASH and the Smoking in Pregnancy Challenge Group published a new report setting out the action needed to turn the Government’s ambitions on smoking in pregnancy and a smokefree society into a reality.
The report was launched at a joint meeting of the APPG on Smoking and Health and the APPG on Baby Loss. The event was attended by the Public Health Minister Jo Churchill, who reaffirmed the Government’s commitment to tackling smoking in pregnancy.
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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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