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Health Education England (HEE) is to be incorporated into NHS England (NHSE) by April 2023, HSJ has learned.
The decision – which is due within days — marks the climax of a long-running battle over HEE’s budget between the organisation and the Treasury. Several senior sources have confirmed the funding settlement HEE was arguing for was considered unaffordable, leading to the effective end of the independent education body.
Last month, the Treasury failed to confirm the NHS’ education and training budgets when issuing its three-year spending plans. The omission included any ongoing budget for HEE. The HEE’s 2020-21 budget was £3.9 billion. HSJ understands HEE was arguing for a significant uplift.
A senior NHS workforce source told HSJ: “There is huge pressure on NHSE to invest in the HEE budget. This [the merger] seems to be the price.” HSJ understands that senior HEE figures view the decision as disappointing, believing the organisation could have been further developed as an independent body. However, they also consider the move as the right long-term decision. It will align finance and workforce planning, and most significantly, bring education and training spending within the NHS England funding allocation, which has been ring-fenced from government spending cuts in recent years.
King’s Fund chief executive Richard Murray said: “While there is logic to it, this move alone will not address staff shortages in the NHS. The workforce crisis has become a blind spot for the government, which has made promises, pledges and manifesto commitments but failed to back the fully funded workforce strategy needed to chart a path out of the staffing crisis. This needs to change - one step in the right direction would be to accept an amendment to the Health and Care Bill that would see the regular publication of workforce projections and enable a longer-term approach to workforce planning.”
Source: HSJ, 17 November 2021
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Research by the British Lung Foundation (BLF) found that covid restrictions have significantly increased the number of undiagnosed cases of Chronic obstructive pulmonary disease (COPD).
More than 45,000 people in the UK could be living with severe lung disease but are unaware of it after diagnosis rates halved in the past year, BLF has warned. The largest-ever survey of COPD suggests as many as 46,000 people have shown persistent symptoms of the disorder in the past 12 months, such as breathlessness, coughing and wheezing, but have not been diagnosed. This is likely to be largely due to essential diagnostic breathing tests being suspended because of fears around the spread of covid and long waits to see specialists more generally, as well as low public awareness of the disease.
COPD is an umbrella term for a group of lung conditions that affect an estimated 2.6 million people in the UK and causes breathing difficulties such as chronic bronchitis and emphysema. To get an accurate diagnosis of COPD, people should be having a specific diagnostic test called spirometry and be asked about smoking, work and lifestyle history, the foundation says. To do this, they need to get an appointment with their GP or respiratory nurse.
Sarah Woolnough, Chief Executive at BLF, said: “It’s heart-breaking that people with COPD are being left without a diagnosis and the treatment they need. The growing numbers of undiagnosed people with COPD is a ticking time bomb for the NHS. Before the pandemic struck, treating people with COPD that had a delayed diagnosis put huge pressure on our health system. With Covid-19 having such a dramatic impact on diagnosis rates, the pressure will only intensify if action is not taken.”
Alison Cook, director of external affairs at Asthma UK and chairwoman of the Taskforce for Lung Health, a collaboration of 30 groups, said: “We need to make a concerted effort to find people who have chronic obstructive pulmonary disease and offer them the treatment they need. That means raising awareness that breathlessness is not normal, even as you get older so that people go to see their GP if they notice a change.”
Source: iNews, 17 November 2021
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According to tobacco control advocates, nearly two-thirds of adults and many retailers would support raising the legal age for purchasing tobacco from 18 to 21.
Fresh, a regional tobacco-control programme in the Northeast of England, said a survey carried out with YouGov found that increasing the age of sale from 18 to 21 had to support 63% of adults in England. About 74% of the public also said they would like to see England becoming smoke-free by 2030.
Fresh argued that the problem had become even more acute because research has indicated that the number of 18- to 34-year-olds who smoke increased by 25% during the first lockdown. Ailsa Rutter, director of Fresh, said: “We need new measures to cut smoking without delay, and this is no more difficult to enforce than the law currently. Raising the age of sale to 21 will go a significant way towards turning off the tap of a new generation of smokers and would be no more difficult to enforce than the law now.”
Source: Talking Retail, 17 November 2021
See also: APPG report - Delivering a Smokefree 2030: The All Party Parliamentary Group on Smoking and Health recommendations for the Tobacco Control Plan 2021
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According to new research, death from a heart attack or stroke may be the first cardiovascular disease (CVD) event for some smokers, and CVD is a major health issue for smokers.
The researchers pooled data from nine long-term cohort studies in the US to evaluate multiple lifestyle factors and cardiovascular and other health outcomes. The analysis included data from 106,165 adults (50.4% women; 16.2% Black adults; 50.1% cigarette smokers) between the ages of 20 and 79, who were free of cardiovascular disease at the start of the studies. The new analysis categorised participants by smoking status, age (young: 20-39 years old, middle-aged: 40-59 years old, older: 60-79 years old), and sex.
Using the combined data, researchers estimated the number of years lived with and without cardiovascular disease according to smoking status and then examined the association between smoking and cardiovascular events after accounting for death from other diseases such as lung cancer. The study researchers found that the biggest difference in risk of death between the smoking and non-smoking participants occurred during middle age. Results of analysis reveal:
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Middle-aged women who smoked were nearly twice as likely as non-smoking women to have a fatal CVD event as their first sign of CVD.
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Middle-aged men who smoked had a 79% chance of having a fatal CVD event as their first sign of cardiovascular disease — about 1.5 times more likely than middle-aged men who did not smoke.
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Middle-aged women who smoked had a higher risk of CVD than non-smokers (34.7% for smokers and 24.8% for non-smokers).
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Middle-aged men who smoked had higher risk of CVD than men who did not smoke (46% for smokers and 35.8% for non-smokers).
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Smoking was associated with the development of cardiovascular disease at an earlier age, by 5 years in middle-aged men and nearly 4 years in middle-aged women. Similar results were seen in younger and older adults. Across all age and gender groups, non-smoking participants lived more years without CVD.
Based on these results, the researchers suggest that all people who smoke should talk with their physicians or other health care professionals about taking steps toward quitting and improving their cardiovascular health.
Source: Medical Xpress, 17 November 2021
See also: JAHA - Cigarette Smoking and Competing Risks for Fatal and Nonfatal Cardiovascular Disease Subtypes Across the Life Course
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Civil society organisations have urged EU commissioners to withdraw their participation from a major event - organised in collaboration with Japan Tobacco International (JTI). The European Business Summit is a high-profile event taking place in Brussels this week (Wednesday 17 and Thursday 18 November) – with a large presence of EU high-level policymakers and business leaders.
According to the event’s website, partners “get the opportunity to influence the EU decision-making process” by bringing their views to an audience full of policymakers and thanks to “unique networking moments.”
However, the group of NGOs has argued that the European Commission’s presence in this event “will undoubtedly be used to create an appearance of respectability for a [tobacco] company – and indeed an industry – with an abysmal track record.”
They also pointed out that commissioners’ participation in an event with a tobacco company as a partner and speaker is against the World Health Organization’s Framework Convention on Tobacco Control, “based on the principle that the interest of the tobacco industry is incompatible with the public interests.” This global treaty, which the EU signed in 2005, calls on countries to reject partnerships with the tobacco industry, urging parties to “protect their policies from commercial and other vested interests of the tobacco industry.”
Source: EU Observer, 17 November 2021
See also: NGO’s letter
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Yesterday (17th November), Mike Amesbury MP, Shadow Minister for Housing, led a backbench debate on support for people with chronic obstructive pulmonary disease. Mr Amesbury welcomed the priority given to COPD in the NHS long-term plan but urged the government to provide early intervention measures and improvements to patients with chronic respiratory conditions. Mr Amesbury asked the Minister to give an update on the new Tobacco Control Plan, and how the Government intends to fund an effective, high-quality stop smoking service throughout the country.
Liz Twist MP spoke about the need for the government to adequately fund public health services and calls on the government to introduce a polluter pays levy on tobacco firms to help fund the cost of ending smoking, as recommended by the All-Party Parliamentary Group on Smoking and Health. Ms Twist called on the Government to ensure stop smoking services can be easily accessed by those already diagnosed with COPD and highlighted that next Tobacco Control Plan would play a crucial part in preventing COPD.
Responding for the Opposition, Justin Madders MP, Shadow Minister for Secondary Care, Workforce and Patient Health spoke about how decades of cuts to the public health grant have reduced smoking cessation services.
Responding for the Government, Minister for Care and Mental Health, Gillian Keegan said:
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That the Government was determined to support people with COPD and had rolled out “guidance and initiatives” over the last ten years to support this area.
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Noted the 2011 outcomes strategy for COPD and asthma and the 2013 guide for performing spirometry.
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That pulmonary rehabilitation would be expanded by 2028 as part of the NHS long-term plan.
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That the government had set an ambition of being smoke free in England by 2030, and the NHS long-term plan commits to NHS tobacco treatment services.
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Reiterated that the Government will publish a new Tobacco Control Plan with an even sharper focus on tackling health disparities to support the Government’s levelling-up agenda.
Source: Hansard, 17 November 2021
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Smoking: Children
Asked by Mr Nicholas Brown, Newcastle upon Tyne East
To ask the Secretary of State for Health and Social Care, what steps he is taking to reduce the (a) appeal and (b) availability of (i) e-cigarettes and (ii) other nicotine products to children.
Answered by By Maggie Throup, The Parliamentary Under-Secretary for Health and Social Care
E-cigarettes in the United Kingdom are regulated by the Tobacco and Related Products Regulations 2016 (TRPR) and the Nicotine Inhaling Products (Age of Sale and Proxy Purchasing) Regulations 2015 (NIP). These regulations aim to reduce the risk of harm to children and include restrictions on mainstream television and radio advertising; requirements on the packaging and labelling of e-cigarettes, prevent sale to under 18s; and limit both tank sizes and nicotine content.
We are currently undertaking a post implementation review of TRPR to assess if the regulations are meeting their objectives. The Government aims to publish its response by the end of the year. The post implementation review on the Nicotine Inhaling Products (Age of Sale and Proxy Purchasing) Regulations 2015 is available at the following link:
Tobacco legislation coming into force between 2010 and 2015: post implementation review - GOV.UK (www.gov.uk)
Source: Hansard, 15 November 2021
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