Recommendations & Conclusions
31 items
1
Conclusion
Second Report - Delivering core NHS and…
The pandemic has presented an unprecedented challenge to the NHS and the Government. Whilst we have no doubt that often communication to patients was as effective as could reasonably be expected in the context of a pandemic, this was not always the case. As we set out in our letter …
Government response. Delivering core NHS and care services during the pandemic and beyond 17 B. Recommendation at paragraph 140: Definition of Workforce Burnout and monitoring/assessing staff wellbeing We further recommend that NHSE/I should develop a full and comprehensive definition of “workforce burnout” …
Department of Health and Social Care
2
Recommendation
Second Report - Delivering core NHS and…
Notwithstanding the actions taken to date, we recommend that NHS England & Improvement review, as a matter of priority, the directions given to NHS Trusts about how to communicate with patients about the progress of their treatment and important medical guidance in any future spike or second wave. As part …
Government response. NHS England and NHS Improvement (NHSE/I) recognises the importance of effective communication with patients. The NHS Standard Contract requires providers to communicate effectively with patients, in a way they can understand, about their condition, its treatment and management, including in …
Department of Health and Social Care
3
Conclusion
Second Report - Delivering core NHS and…
The pandemic has placed an unprecedented burden on the delivery of core NHS and care services. This has resulted in the delay, suspension or cancellation of services which in turn has inevitably led to a significant increase in waiting times, the backlog of appointments and pent-up demand for medical treatments. …
Government response. The Government recognises the unprecedented burden that the pandemic has placed on the delivery of core NHS and care services. The Government is committed to ensuring that patients are able to access the medical treatment they require. NHS England and …
Department of Health and Social Care
4
Conclusion
Second Report - Delivering core NHS and…
We recognise the commitment of policy makers and the NHS leadership to restoring core NHS services and the ongoing efforts to manage the backlog. We are also grateful for the hard work of all staff and the use of innovative methods to support core NHS services during the pandemic, including: …
Department of Health and Social Care
5
Conclusion
Second Report - Delivering core NHS and…
During our session on 30 June 2020, Sir Simon Stevens told us that he “expects” waiting times for and referrals to core health services to “go up quite significantly over the second half of the year.” We also heard from Sir Simon, Amanda Pritchard and Professor Steve Powis of the …
Government response. For elective care, the official statistics show that waiting times have been impacted by the pandemic, from a combination of enhanced IPC measures, and patients choosing to defer their care. The pace of recovery of elective care since the first …
Department of Health and Social Care
6
Recommendation
Second Report - Delivering core NHS and…
We recommend that the Department of Health & Social Care and NHSE/I provide an update on what steps they have, individually and collectively, taken and are planning to take to quantify and address the overall impact of the pandemic on waiting times, the backlog of appointments and pent-up, and as …
Government response. For elective care, the official statistics show that waiting times have been impacted by the pandemic, from a combination of enhanced IPC measures, and patients choosing to defer their care. The pace of recovery of elective care since the first …
Department of Health and Social Care
7
Conclusion
Second Report - Delivering core NHS and…
We also recommend that NHSE/I provides us with a more broader update on what positive innovations or changes have taken place in the NHS during the pandemic, and how it seeks to ensure all the positive changes that have occurred are captured and potentially implemented across the entire NHS. We …
Department of Health and Social Care
8
Conclusion
Second Report - Delivering core NHS and…
We further conclude that the delivery of dental services in England has been significantly hindered by the pandemic. This has been largely due to the need to protect both patients and staff from COVID-19 which has, in turn, presented financial challenges to both NHS and private dental practices. We welcome …
Government response. The backlog in dental appointments is a function of the precautions needed to avoid infection through COVID-19. DHSC acknowledges the impact that the coronavirus pandemic has had on the provision of NHS dentistry across the country and is working with …
Department of Health and Social Care
9
Recommendation
Second Report - Delivering core NHS and…
We are concerned that there does not appear to be a plan for the restoration of dental services in England. We recommend that Sara Hurley (Chief Dental Officer for England) sets out her assessment of the challenges facing dentistry services in England, and clarifies what steps will be taken to …
Government response. The Chief Dental Officer for England’s remit extends to clinical policy and does not cover operational delivery or contracting, which sits with the Department of Health & Social Care and the NHS. This assessment has focussed on the restoration of …
Department of Health and Social Care
10
Conclusion
Second Report - Delivering core NHS and…
We recognise the unprecedented scale of the challenge facing the Government and NHSE/I to keep NHS and care staff safe during the pandemic. As in other countries facing the pandemic there were, however, persistent failures with the procurement and supply of appropriate personal protective equipment (PPE) to some NHS and …
Government response. The government is confident that there will be a consistent supply of PPE this winter. Since the initial PPE Plan in April, the UK PPE supply chain has stabilised; there are around 32 billion PPE items on order and there …
Department of Health and Social Care
11
Conclusion
Second Report - Delivering core NHS and…
We request an update from the Department of Health & Social Care by the end of November 2020 on what steps are being taken to ensure that there is a consistent and reliable supply of appropriately fitting PPE to all NHS staff in advance of the onset of winter and …
Government response. The government is confident that there will be a consistent supply of PPE this winter. Since the initial PPE Plan in April, the UK PPE supply chain has stabilised; there are around 32 billion PPE items on order and there …
Department of Health and Social Care
12
Conclusion
Second Report - Delivering core NHS and…
We are grateful to Professor Chris Whitty (Chief Medical Officer) and his expert colleagues for their continued and constructive engagement with our work. We also recognise that the Government, following the advice of the Chief Medical Officer and others, has taken a considered approach to implementing the SIREN study. We …
Government response. We are grateful to Professor Chris Whitty and his expert colleagues for their continued engagement with the Committee’s work. The Government has taken a considered approach to implementing the SIREN study, following the advice of the Chief Medical Officer and …
Department of Health and Social Care
13
Conclusion
Second Report - Delivering core NHS and…
We accept the advice we have received from many eminent scientists that there is a significant risk that not testing NHS staff routinely could lead to higher levels of nosocomial infections in any second spike. We therefore urge the Government to set out clearly why it is yet to implement …
Government response. The Government recognises the concerns of the Committee and eminent scientists who advise that not testing NHS staff routinely could lead to higher levels of nosocomial infections in any second spike. Routine asymptomatic testing is an important component of the …
Department of Health and Social Care
14
Conclusion
Second Report - Delivering core NHS and…
We note that Professor Chris Whitty has said that the testing of asymptomatic staff may be necessary in the future and that if there is a “surge in winter” of coronavirus cases then he would be likely to advise that routine testing of NHS staff should take place. However, we …
Government response. The Government recognises the concerns of the Committee and eminent scientists who advise that not testing NHS staff routinely could lead to higher levels of nosocomial infections in any second spike. Routine asymptomatic testing is an important component of the …
Department of Health and Social Care
15
Conclusion
Second Report - Delivering core NHS and…
We ask that Professor Whitty sets out to what extent testing capacity has impacted the advice he and his colleagues have provided to the Government on routine testing of NHS staff. We further ask Professor Whitty to clarify whether he has advised the Government to introduce routine testing of all …
Government response. The Government recognises the concerns of the Committee and eminent scientists who advise that not testing NHS staff routinely could lead to higher levels of nosocomial infections in any second spike. Routine asymptomatic testing is an important component of the …
Department of Health and Social Care
16
Recommendation
Second Report - Delivering core NHS and…
We conclude that the case for routine testing of all NHS staff in all parts of the country (including clinical staff as well as cleaners, porters and so forth) is compelling and should be introduced as quickly as capacity allows and before the winter-flu season begins. Those who—either directly or …
Government response. The Government recognises the concerns of the Committee and eminent scientists who advise that not testing NHS staff routinely could lead to higher levels of nosocomial infections in any second spike. Routine asymptomatic testing is an important component of the …
Department of Health and Social Care
17
Recommendation
Second Report - Delivering core NHS and…
We recommend that, by the end of October 2020, the Government and NHSE/I set out: i) what current capacity there is for testing all NHS staff, ii) what further capacity (if any) will be required and iii) how long it is likely to take to secure sufficient capacity to offer …
Government response. The Government recognises the concerns of the Committee and eminent scientists who advise that not testing NHS staff routinely could lead to higher levels of nosocomial infections in any second spike. Routine asymptomatic testing is an important component of the …
Department of Health and Social Care
18
Conclusion
Second Report - Delivering core NHS and…
We are extremely grateful to all NHS and care staff for their hard work and dedication in trying to meet patient needs in such exceptional circumstances. This includes those who have returned to the NHS (such as clinicians returning from academia, retirement and other industries); students who have left their …
Government response. The NHS People Plan 2020/21 was published in July, with a strong emphasis on ‘Looking after our People’—including 23 commitments related to health and wellbeing—and ‘Belonging in the NHS’ with a focus on addressing inequalities within the NHS workforce. The …
Department of Health and Social Care
19
Conclusion
Second Report - Delivering core NHS and…
We are grateful for NHSE/I’s continued support of NHS staff and welcome the further measures set out in the People Plan (July 2020) for the 2020–21 period. In particular, we welcome the important and ambitious measures set out in the People Plan which show a clear desire to address workforce …
Government response. The measures I have outlined above are designed to mitigate the psychological impact of these pressures, however it is also critical that we continue to increase workforce supply and improve the retention of staff, and I provide further detail on …
Department of Health and Social Care
20
Recommendation
Second Report - Delivering core NHS and…
We recommend that NHSE/I set out in detail what further specific steps it would like to take over the coming years to support the mental and physical wellbeing of all staff and a plan to deal with the specific issue of sustained workplace pressure due to the current pandemic and …
Government response. The measures I have outlined above are designed to mitigate the psychological impact of these pressures, however it is also critical that we continue to increase workforce supply and improve the retention of staff, and I provide further detail on …
Department of Health and Social Care
21
Recommendation
Second Report - Delivering core NHS and…
We further recommend that NHSE/I should develop a full and comprehensive definition of “workforce burnout”, and set out how the wellbeing of all NHS staff is being monitored and assessed. This information should be made available to us by the middle of October 2020, to enable us to scrutinise it …
Government response. The measures I have outlined above are designed to mitigate the psychological impact of these pressures, however it is also critical that we continue to increase workforce supply and improve the retention of staff, and I provide further detail on …
Department of Health and Social Care
22
Conclusion
Second Report - Delivering core NHS and…
We note, meanwhile, that there is no equivalent of the NHS People Plan for the social care workforce. We will have more to say about support for those working in social care in our forthcoming report on Social care: workforce and funding. (Paragraph 141) Support for BAME NHS staff members
Government response. The Government agrees with the Committee’s comments and will address the social care workforce in the upcoming White Paper for Social Care Reform.
Department of Health and Social Care
23
Conclusion
Second Report - Delivering core NHS and…
The NHS is founded on the principle of equality and is one of the most diverse and inclusive organisations in the UK. It hugely benefits from the diversity of its staff as in turn so does the nation. In recent months, there has been a much-needed focus on supporting NHS …
Government response. In response to your request for a comprehensive definition of the racism and discrimination that we are seeking to eradicate from the NHS, our approach is aligned to the respective definitions in the Race Relations Act 1976 and Equalities Act …
Department of Health and Social Care
24
Conclusion
Second Report - Delivering core NHS and…
We have also heard that some BAME NHS staff face discrimination and racism in the NHS and that, across the NHS, the levels of diversity must be improved. We accept Sir Simon Stevens’ comments that “there are systemic features to discrimination and racism, and the NHS is both part of …
Government response. In response to your request for a comprehensive definition of the racism and discrimination that we are seeking to eradicate from the NHS, our approach is aligned to the respective definitions in the Race Relations Act 1976 and Equalities Act …
Department of Health and Social Care
25
Conclusion
Second Report - Delivering core NHS and…
The NHS must increase its efforts to eradicate all forms of discrimination and racism from in its organisation. We therefore recommend that NHSE/I provide a full and comprehensive definition of the “racism and discrimination” that it seeks to eradicate from the NHS. We invite NHSE/I and the Department for Health …
Government response. In response to your request for a comprehensive definition of the racism and discrimination that we are seeking to eradicate from the NHS, our approach is aligned to the respective definitions in the Race Relations Act 1976 and Equalities Act …
Department of Health and Social Care
26
Conclusion
Second Report - Delivering core NHS and…
Historically, accident and emergency departments have been over-stretched, over- burdened and running over capacity. We have heard that the initial decline in patient attendances at A&E departments during the pandemic to some extent “cured” the problem of “corridor care”. However, as presentations at A&E begin to increase, the Government and …
Government response. The Government recognises the importance of ensuring that emergency departments do not become overwhelmed by patient demand and remain able to provide high-quality and safe treatment for all patients. NHS England and NHS Improvement (NHSE/I) have been working with NHS …
Department of Health and Social Care
27
Recommendation
Second Report - Delivering core NHS and…
We welcome the news that the Government and NHSE/I are piloting a ‘111 dial first’ scheme to support the triaging of patients before they attend A&E departments. The introduction of an expectation that a patient will call first before walking into an A&E department is a sensible change to support …
Government response. The Government welcomes the Committee’s support for the ‘111 dial first’ scheme. NHS England and NHS Improvement (NHSE/I) are piloting this scheme in a number of areas across the country. The aim of the scheme is to support the triaging …
Department of Health and Social Care
28
Conclusion
Second Report - Delivering core NHS and…
We welcome the support of the Secretary of State and the Chief Executive of NHSE/I for technological innovation in the NHS. The use of technology and digital alternatives (“telemedicine”), although it has had a mixed response from some patients and medical practitioners, shows that the NHS is innovating. We also …
Government response. The Government welcomes the Committee’s support for technological innovation in the NHS. The use of technology and digital alternatives (“telemedicine”) has the potential to improve productivity across the healthcare system and provide patients with more convenient access to care. The …
Department of Health and Social Care
29
Recommendation
Second Report - Delivering core NHS and…
We recommend that NHSE/I and the Department for Health & Social Care set out their assessment of how effective the use of technology and digital alternatives (“telemedicine”) has been across all health and care services. As part of this assessment, we ask that both NHSE/I and the Department to clearly …
Government response. The Government agrees with the Committee that it is important to assess the effectiveness of the use of technology and digital alternatives (“telemedicine”) across all health and care services. NHS England and NHS Improvement (NHSE/I) are currently undertaking a review …
Department of Health and Social Care
30
Conclusion
Second Report - Delivering core NHS and…
We commend the efforts of the Government, NHSE/I and the independent sector for stepping up and securing independent sector capacity (i.e. beds, staff and facilities) which has been crucial to supporting the NHS during the pandemic. It is clear that such independent sector capacity will be needed over the coming …
Government response. The Government agrees with the Committee that independent sector capacity will be needed over the coming months as the restoration of core healthcare services is prioritised, particularly over the winter period. The Government has secured independent sector capacity (i.e. beds, …
Department of Health and Social Care
31
Recommendation
Second Report - Delivering core NHS and…
We recommend, in addition to our recommendations in Chapter 2, that the Government and NHSE/I clarify what plans there are to continue to use independent bed capacity and other independent resources as the winter period approaches. We further recommend that the Government and NHSE/I set out i) what the current …
Government response. Maximising effective treatment capacity both in NHS hospitals and through the independent sector, including—where locally feasible— dedicated non-covid treatment hubs. Prior to the second covid wave, we had seen strong elective recovery across the NHS, with overnight elective operations approaching …
Department of Health and Social Care