Recommendations & Conclusions
34 items
1
Conclusion
Ninth report - Clearing the backlog cau…
Our key new recommendation is that, by April 2022, the Department of Health and Social Care works with NHS England to produce a broader national health and care recovery plan that goes beyond the elective backlog to emergency care, mental health, primary care, community care and social care. It should …
Government response. Accept in principle. The Government recognises the importance of the NHS and the social care system working together to address the challenges they face. The Health and Care Act 2022 legislates to ensure effective partnership working at all levels across …
Department of Health and Social Care
2
Conclusion
Ninth report - Clearing the backlog cau…
It is not appropriate to set a numerical target for the proportion of appointments carried out remotely in general practice. Instead practices should respond to the needs of their local populations and work together with patients to establish the most fitting medium for their consultations based on clinical outcomes. Remote …
Government response. Accept. It is not appropriate to set a numerical target for the proportion of appointments carried out remotely in general practice. Instead, practices should respond to the needs of their local populations and work together with patients to establish the …
Department of Health and Social Care
3
Recommendation
Ninth report - Clearing the backlog cau…
NHS England has already commissioned an evaluation of the role of digital tools in primary care. We recommend that it publishes that evaluation at the earliest opportunity and uses it as a basis to produce clear and consistent guidance on best practice in • Reducing bureaucracy and day-to-day IT administration …
Government response. NHS England has commissioned an evaluation of the role of digital tools in primary care, which has now concluded. NHS England is currently considering the findings of the evaluation and will publish clear and consistent guidance on best practice in …
Department of Health and Social Care
4
Recommendation
Ninth report - Clearing the backlog cau…
We further recommend that NHS England looks beyond primary care in its assessment of the use of digital tools and considers the impact of an increased usage of such tools not only on patients, but also on other parts of the health and care system, especially at the primary care …
Government response. NHS England has commissioned an evaluation of the role of digital tools in primary care, which has now concluded. NHS England is currently considering the findings of the evaluation and will publish clear and consistent guidance on best practice in …
Department of Health and Social Care
5
Conclusion
Ninth report - Clearing the backlog cau…
Managed well, we see enormous potential for a beefed-up version of 111 to regulate the demands on emergency departments and ensure that patients get the right care, in the right place, at the right time. However, we acknowledge concerns that without sufficient clinical validation these objectives cannot be met. Without …
Government response. NHS England are evaluating the NHS 111 First service, and a final evaluation report will be published in due course. This will assess the impact of the service on emergency departments and patient outcomes.
Department of Health and Social Care
6
Conclusion
Ninth report - Clearing the backlog cau…
We therefore recommend that NHS England completes and publishes evaluations of NHS 111 call first services as soon as is practicable, including learning from those evaluations and the implications for any future iterations of the service.
Government response. The NHS is committed to evaluating services to ensure that they are providing high quality care for patients. NHS England is currently undertaking further detailed analysis of the NHS 111 First programme. We expect the results of this analysis to …
Department of Health and Social Care
7
Conclusion
Ninth report - Clearing the backlog cau…
The response to long covid shows both the kind of integrated, patient-centred care the NHS can provide when systems work effectively, and the frustration and detriment experienced by patients who have to “fight” to access to the right care when systems do not work effectively. We heard that long covid …
Government response. The Government recognises the importance of supporting those suffering from long COVID, with over £50 million invested into research to better understand the condition, and over 90 specialist clinics established across the country. These clinics adopt a multi-disciplinary approach, bringing …
Department of Health and Social Care
8
Conclusion
Ninth report - Clearing the backlog cau…
We therefore recommend that NHS England publishes, before the end of this financial year, a long covid plan covering the period until 2023. The plan must be developed in consultation with a wide range of stakeholders, including patient groups. NHS England should integrate this into its wider health and care …
Government response. NHS England published its Delivery plan for tackling the COVID-19 backlog of elective care in March 2022, which included commitments to optimising pathways for patients with long COVID and ensuring they can access timely and appropriate support. The plan made …
Department of Health and Social Care
9
Conclusion
Ninth report - Clearing the backlog cau…
It is not acceptable for patients awaiting planned treatment or feeling the debilitating effects of long covid to feel “abandoned” by the NHS. We appreciate the uncertainty about the length of future waiting lists, but this is no excuse for lack of communication—whether this be confirmation of a patient’s next …
Government response. The Government agrees that communication with patients is essential. NHS England has been working to improve communication with patients waiting for treatment, and has published guidance for providers on how to do this effectively. This includes providing patients with regular …
Department of Health and Social Care
10
Conclusion
Ninth report - Clearing the backlog cau…
The national health and care recovery plan must set out a clear vision for what ‘success’ in tackling the backlog will look like, and what patients can expect their care to look like in their local area in the coming years. The plan must include minimum expectations for ICBs in …
Government response. Accept in principle. NHS England is responsible for setting out a clear vision for what ‘success’ in tackling the elective backlog will look like, and what patients can expect their care to look like in their local area in the …
Department of Health and Social Care
11
Conclusion
Ninth report - Clearing the backlog cau…
Lastly, we heard that patient involvement in services was important to tackle long covid. It should also be taking place in other areas. We have previously called for the Care Quality Commission’s assessments of Integrated Care Systems (ICSs) to include consultation with patient groups and patient outcomes, and we continue …
Government response. Accept in principle. The Government agrees that patient involvement in services is important, and that this should be taking place in all areas of health and care. The Care Quality Commission’s assessments of Integrated Care Systems (ICSs) already include consultation …
Department of Health and Social Care
12
Conclusion
Ninth report - Clearing the backlog cau…
We again recommend that the Care Quality Commission includes consultation with patient groups and details of patient outcomes in its assessment of ICSs. (Paragraph 68) Funding and policies to tackle the backlog
Government response. Accept in principle. The Government agrees that patient involvement in services is important, and that this should be taking place in all areas of health and care. The Care Quality Commission’s assessments of Integrated Care Systems (ICSs) already include consultation …
Department of Health and Social Care
13
Conclusion
Ninth report - Clearing the backlog cau…
The pandemic has had a negative impact on health inequalities and highlighted the crucial importance of effective public health services in supporting local populations. Public health services are therefore vital allies in tackling the backlog, and we are surprised at the decision merely to maintain current public health grant funding …
Government response. Partially accept. The Government recognises the crucial importance of effective public health services in supporting local populations, and the negative impact that the pandemic has had on health inequalities. Public health services are vital in tackling the backlog, and this …
Department of Health and Social Care
14
Recommendation
Ninth report - Clearing the backlog cau…
As part of its national health and care recovery plan, we recommend that the Government sets out the contribution that public health services will make, and ensures that this contribution is backed with a level of funding that acknowledges their crucial role.
Government response. Partially accept. The Government recognises the crucial importance of effective public health services in supporting local populations, and the negative impact that the pandemic has had on health inequalities. Public health services are vital in tackling the backlog, and this …
Department of Health and Social Care
15
Conclusion
Ninth report - Clearing the backlog cau…
We note that the Government decided to resist an amendment to the Health and Care Bill that would have required it to publish independently verified assessment of health, social care and public health workforce numbers at least once every two years, leaving a gap between its rhetoric about supporting frontline …
Government response. Accept in principle. The Government recognises the importance of supporting frontline staff and the need for independently verified assessment of health, social care and public health workforce numbers. The Government publishes independently verified assessment of health, social care and public …
Department of Health and Social Care
16
Recommendation
Ninth report - Clearing the backlog cau…
We repeat our recommendation that HEE must be required (whether in its own right or as part of NHS England) to publish objective, transparent and independently-audited annual reports on workforce projections that cover the next five, ten and twenty years, including an assessment of whether sufficient numbers of staff are …
Government response. Accept in principle. As set out in the response to recommendation 15, the Government recognises the importance of supporting frontline staff and the need for independently verified assessment of health, social care and public health workforce numbers. The Government publishes …
Department of Health and Social Care
17
Recommendation
Ninth report - Clearing the backlog cau…
We recommend that the Government undertake an urgent review of short-term recruitment and retention issues within the health and care workforce, including productivity improvements, sharing of best practice through data, removal of professional demarcation, use of technology, additional training places and additional immigration measures. This should be published before the …
Government response. Accept in principle. The Government recognises the importance of addressing short-term recruitment and retention issues within the health and care workforce. NHS England is working to address these issues, and will publish a refreshed People Plan to cover the financial …
Department of Health and Social Care
18
Conclusion
Ninth report - Clearing the backlog cau…
Investing resource in our health and care workforce will ultimately save money— for example through reduced locum and agency fees over time—and help build a better, safer health service. It will also give hope to staff—who are feeling increasing desperate and who face yet more challenges on top of those …
Government response. The Government recognises the importance of investing in the health and care workforce and the need to support them. This is why in the Autumn Statement 2022, the Government reaffirmed its commitment to investing in the NHS workforce. NHS England’s …
Department of Health and Social Care
19
Recommendation
Ninth report - Clearing the backlog cau…
We call on NHS England to demonstrate its ongoing commitment to staff wellbeing by publishing a refreshed People Plan to cover the financial year 2022/23 as soon as is practicable.
Government response. Accept in principle. NHS England is committed to supporting staff wellbeing, and will publish a refreshed People Plan to cover the financial year 2022/23 as soon as is practicable. This plan will set out how NHS England will support staff …
Department of Health and Social Care
20
Conclusion
Ninth report - Clearing the backlog cau…
An NHS running too ‘hot’ for patients to move from crowded emergency departments into wards cannot provide safe, efficient or effective care in the long- term. Furthermore, the advent of ICSs offers an opportunity to provide patients with more integrated care so that they can leave hospital promptly once medically …
Government response. Accept in principle. The Government recognises that an NHS running too ‘hot’ for patients to move from crowded emergency departments into wards cannot provide safe, efficient or effective care in the long-term. Furthermore, the advent of Integrated Care Systems offers …
Department of Health and Social Care
21
Recommendation
Ninth report - Clearing the backlog cau…
As part of its broader health and care recovery plan, the Government must produce an independently-verified analysis of how many, and what type, of extra beds the NHS needs in order to provide safe and effective everyday care for patients, whilst also responding to need directly created by the pandemic. …
Government response. Accept in principle. The Government recognises the importance of ensuring that the NHS has the capacity it needs to provide safe and effective everyday care for patients, whilst also responding to need directly created by the pandemic. NHS England is …
Department of Health and Social Care
22
Conclusion
Ninth report - Clearing the backlog cau…
We welcome the £2.3bn pledged in the Spending Review to create around 100 new community diagnostic hubs, but we are yet to see detailed plans for their implementation.
Government response. Noted. We welcome the £2.3 billion pledged in the Spending Review to create around 100 new community diagnostic hubs, and detailed plans for their implementation will be set out in due course.
Department of Health and Social Care
23
Recommendation
Ninth report - Clearing the backlog cau…
Ahead of the arrival of the new funding from the Spending Review in Spring 2022, we recommend that Government provides more details on the 100 new community diagnostic hubs, including where they will be placed, who will staff them and how they will contribute to service improvement within and beyond …
Government response. NHS England and NHS Improvement are working with systems to develop community diagnostic centres, with over 90 sites now open across the country. These centres are designed to provide a range of services based on local need, including MRI, CT, …
Department of Health and Social Care
24
Conclusion
Ninth report - Clearing the backlog cau…
Access to care should not be dependent on where you live in the country. Regional and national co-ordination will be necessary to ensure that strategies aimed at tackling the backlog do not have the unintended consequence of increasing health inequalities.
Government response. The Elective Recovery Taskforce is working to ensure that innovative solutions to tackling the backlog are adopted across the country to ensure that access to care is not dependent on where you live. This includes supporting collaboration between systems and …
Department of Health and Social Care
25
Recommendation
Ninth report - Clearing the backlog cau…
We recommend that NHS England, together with ICBs and the new Office for Health Improvement and Disparities (OHID), work together to deliver regional and national coordination as the system tackles the backlog in elective care. If the independent sector is to prove an effective partner in tackling that backlog, the …
Government response. The Elective Recovery Taskforce is working to ensure that innovative solutions to tackling the backlog are adopted across the country to ensure that access to care is not dependent on where you live. This includes supporting collaboration between systems and …
Department of Health and Social Care
26
Conclusion
Ninth report - Clearing the backlog cau…
We have heard much about how a robust social care system that can support hospital discharges and free up capacity is essential to clear the backlog. We welcome the inclusion of the social care workforce in the refreshed Framework 15. Social care, however, did not receive an adequate settlement in …
Government response. The Government recognises the importance of social care in supporting hospital discharge and freeing up capacity. The Government has made available up to £7.5 billion over the next two years to support adult social care and discharge. This includes: • …
Department of Health and Social Care
27
Recommendation
Ninth report - Clearing the backlog cau…
In light of the Government’s commitment to reform social care, we again recommend that it publishes a ten-year plan for social care, setting out how it in detail how it will tackle the structural and financial problems the sector faces in the short-term, and operationalise its longer-term ambitions. The Government …
Government response. The Government recognises the importance of social care in supporting hospital discharge and freeing up capacity. The Government has made available up to £7.5 billion over the next two years to support adult social care and discharge. This includes: • …
Department of Health and Social Care
28
Conclusion
Ninth report - Clearing the backlog cau…
To encourage better integration and mutual understanding across health and social care, we again recommend that a duty is placed on ICSs so that where a decision by an ICS affects carers and the social care sector, the ICS must undertake a formal consultation with the groups and sectors affected.
Government response. The Government agrees with the importance of integration across health and social care. The Health and Care Act 2022 places a duty on ICBs to promote integration. Statutory guidance will be published to support implementation of the Act. This will …
Department of Health and Social Care
29
Conclusion
Ninth report - Clearing the backlog cau…
There is enormous potential for technology to support a transformation in NHS care that will bring benefits for patients and staff alike. However, this potential will not be realised while many providers still struggle with basic IT infrastructure. The Wade-Gery report calls for a roadmap for the delivery of its …
Government response. NHS England are committed to publishing a roadmap in response to the Wade-Gery report and intend to do so in Autumn 2022. This will set out how they will put data, digital and tech at the heart of transforming the …
Department of Health and Social Care
30
Conclusion
Ninth report - Clearing the backlog cau…
NHS England must produce its roadmap in response to the Wade-Gery report on Putting data, digital and tech at the heart of transforming the NHS at the earliest opportunity so that we and others are able to scrutinise it ahead of implementation.
Government response. NHS England are committed to publishing a roadmap in response to the Wade-Gery report and intend to do so in Autumn 2022. This will set out how they will put data, digital and tech at the heart of transforming the …
Department of Health and Social Care
31
Conclusion
Ninth report - Clearing the backlog cau…
The upcoming national introduction of ICBs provides the opportunity for local integration and innovation. This opportunity must not be wasted, particularly in the context of the backlog. There must be clear incentives for ICBs to deliver integrated and innovative care, with ICSs held accountable for the care they deliver.
Government response. The Government agrees on the importance of ICBs delivering integrated and innovative care, and that ICSs are held accountable for the care they deliver. The Health and Care Act 2022 places duties on ICBs to promote integration and reduce health …
Department of Health and Social Care
32
Conclusion
Ninth report - Clearing the backlog cau…
We have previously recommended that Care Quality Commission ratings include an assessment of the progress ICBs make on the integration of information technology between primary care, secondary care, and the social care sector. We repeat this recommendation here. Although the CQC is an independent body, we believe that including the …
Government response. The Government agrees on the importance of integrated care and the effective use of technology. The Care Quality Commission (CQC) is an independent body, and it is for them to determine what is included in their ratings. However, the Government …
Department of Health and Social Care
33
Recommendation
Ninth report - Clearing the backlog cau…
We recommend the Government creates a platform to share examples of good practice and innovation at ICB level so that lessons can be learnt, and practices adapted in ways that reflect the health needs of local areas. Without this, the risk of regional inequalities in waiting lists and postcode lotteries …
Government response. NHS England and NHS Improvement are committed to sharing examples of good practice and innovation at ICB level. They are currently developing a platform to share best practice and innovation, which will be launched in Autumn 2022. This will allow …
Department of Health and Social Care
34
Conclusion
Ninth report - Clearing the backlog cau…
We again recommend that a duty be placed on ICBs for them to have regard to mental health and public health. (Paragraph 128) Clearing the backlog caused by the pandemic 39
Government response. The Government agrees that it is important that ICBs have regard to mental health and public health. The Health and Care Act 2022 places a duty on ICBs to have regard to the need to reduce health inequalities, which includes …
Department of Health and Social Care